Mindfulness and pharmacological prophylaxis have comparable effect on biomarkers of inflammation and clinical indexes in chronic migraine with medication overuse: results at 12 months after withdrawal


Chronic migraine (CM) is a disabling condition arising from a complex mixture of interconnected biological, psychological and social factors, and is often associated with medication overuse (MO). Mindfulness is emerging as a helpful treatment for pain, and one study showed that the longitudinal 12 months’ course of CM-MO patients that attended mindfulness-based treatment alone was similar to that of patients receiving medical prophylaxis alone; in this study, we describe the course of biomarkers of inflammation. Our results provide initial evidence of sustained similar effects on reduced concentration of biomarkers of inflammation, although not sizeable enough to reach statistical significance. Whether more intensive treatment and/or larger samples would lead to greater changes is unknown, but these encouraging preliminary findings suggest further research is warranted.

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  1. 1.

    Global Burden of Disease Study 2013 Collaborators (2015) (2013) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386:743–800

    Google Scholar 

  2. 2.

    Manack AN, Buse DC, Lipton RB (2011) Chronic migraine: epidemiology and disease burden. Curr Pain Headache Rep 15:70–78

    Article  PubMed  Google Scholar 

  3. 3.

    Headache Classification Committee of the International Headache Society (2013) The International Classification of Headache Disorders, 3rd edn (beta version). Cephalalgia 33:629–808

  4. 4.

    Bigal M (2009) Migraine chronification-concept and risk factors. Discov Med 8:145–150

    PubMed  Google Scholar 

  5. 5.

    Andrasik F, Grazzi L, Usai S et al (2009) Non-pharmacological approaches to treating chronic migraine with medication overuse. Neurol Sci 30:89–99

    Article  Google Scholar 

  6. 6.

    Grazzi L, Andrasik F, Usai S et al (2009) Treatment of chronic migraine with medication overuse. Is drug withdrawal crucial? Neurol Sci 30:S85–S88

    Article  PubMed  Google Scholar 

  7. 7.

    Candy R, Farmer K, Beach ME et al (2008) Nurse-based education: an office-based comparative model for education of migraine patients. Headache 48:564–569

    Article  Google Scholar 

  8. 8.

    Rosenzweig S, Greeson JM, Reibel DK et al (2010) Mindfulness based stress reduction for chronic pain condition: variation in treatment outcomes and role of home meditation practice. J Psychosom Res 68:29–36

    Article  PubMed  Google Scholar 

  9. 9.

    Castelnuovo G, Giusti EM, Manzoni GM, et al (2016) Psychological considerations in the assessment and treatment of pain in neurorehabilitation and psychological factors predictive of therapeutic response: evidence and recommendations from the Italian consensus conference on pain in neurorehabilitation. Front Psychol 7:468

  10. 10.

    Wells RE, Burch R, Paulsen RH et al (2014) Meditation for migraines: a pilot randomized controlled trial. Headache 54:1484–1495

    Article  PubMed  Google Scholar 

  11. 11.

    Grazzi L, Sansone E, Raggi A et al (2017) Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with chronic migraine: an effectiveness trial with a one-year follow-up. J Headache Pain 18:15

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Tietjen GE, Khubchandani J (2015) Vascular biomarkers in migraine. Cephalalgia 35:95–117

    Article  PubMed  Google Scholar 

  13. 13.

    Durham P, Papapetropoulos S (2013) Biomarkers associated with migraine and their potential role in migraine management. Headache 53:1262–1277

    Article  PubMed  Google Scholar 

  14. 14.

    Grazzi L, Andrasik F, D’Amico D et al (2004) Disability in chronic migraine patients with medication overuse: treatment effects at 1-year follow-up. Headache 44:678–683

    Article  PubMed  Google Scholar 

  15. 15.

    Kabat-Zinn J (2003) Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Pract 10:144–156

    Article  Google Scholar 

  16. 16.

    Uzar E, Evliyaoglu O, Yucel Y et al (2011) Serum cytokine and pro-brain natriuretic peptide (BNP) levels in patients with migraine. Eur Rev Med Pharmacol Sci 15:1111–1116

    CAS  PubMed  Google Scholar 

  17. 17.

    Yan J, Melemedjian OK, Price TJ et al (2012) Sensitization of dural afferents underlies migraine-related behavior following meningeal application of interleukin-6 (IL-6). Mol Pain 8:6

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Wang F, He Q, Ren Z et al (2015) Association of serum levels of intercellular adhesion molecule-1 and interleukin-6 with migraine. Neurol Sci 36:535–540

    Article  PubMed  Google Scholar 

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Correspondence to Licia Grazzi.

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Ethical standards

The studies have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and latest revisions (the latest in 2013). Patient informed consent to be included in the study has been obtained.

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Grazzi, L., D’Amico, D., Raggi, A. et al. Mindfulness and pharmacological prophylaxis have comparable effect on biomarkers of inflammation and clinical indexes in chronic migraine with medication overuse: results at 12 months after withdrawal. Neurol Sci 38, 173–175 (2017). https://doi.org/10.1007/s10072-017-2874-0

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  • Chronic migraine
  • Medication overuse
  • Mindfulness
  • Biomarkers
  • Interleukin-6