Real-Time Assessment of the Effect of Biofeedback Therapy with Migraine: A Pilot Study
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Biofeedback therapy has been reported to be effective in the treatment of migraine. However, previous studies have assessed its effectiveness using paper-and-pencil diaries, which are not very reliable.
The objective of the present pilot study was to investigate the feasibility of using computerized ecological momentary assessment (EMA) for evaluating the efficacy of BF treatment for migraine in a randomized controlled trial.
The subjects comprised one male and 26 female patients with migraine. They were randomly assigned to either biofeedback or wait-list control groups. Patients were asked to carry a palmtop-type computer to record momentary symptoms for 4 weeks before and after biofeedback treatment. The primary outcome measure was headache intensity. The secondary outcome measures included psychological stress, anxiety, irritation, headache-related disability and the frequency (number of days per month) of migraine attack and of headache of at least moderate intensity (pain rating ≥50).
Headache intensity showed significant main effects of period (before vs. after therapy, p = 0.02) and group (biofeedback vs. control groups, p = 0.42) and a significant period × group interaction (p < 0.001). Biofeedback reduced the duration of headaches by 1.9 days, and the frequency of days when headache intensity was ≥50 by 2.4 times. In addition, headache-related disability, psychological stress, depression, anxiety, and irritation were significantly improved.
The present study used computerized EMA to show that biofeedback could improve the symptoms of migraine, including psychological stress and headache-related disability.
KeywordsMigraine Ecological momentary assessment Biofeedback Psychological stress Headache-related disability Multilevel model
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study
Conflict of Interest
Miyuki Odawara, Masahiro Hashizume, Kazuhiro Yoshiuchi, and Koji Tsuboi declare that they have no conflict of interest.
- 14.Goslin RE, Gray RN, McCrory DC, Penzien D, Rains J, Hasselblad V. Behavioral and physical treatments for migraine headache. Technical Review 2.2. Rockville: Agency for Health Care Policy and Research; 1999.Google Scholar
- 16.Stone AA, Shiffman SS. Ecological momentary assessment (EMA) in behavioral medicine. Ann Behav Med. 1994;16:199–202.Google Scholar
- 18.Headache Classification Subcommittee of the International Headache Society. The International classification of headache disorders: 2nd edition. Cephalalgia. 2004;24 suppl 1:9–160.Google Scholar
- 26.Beckham AJ, Greene TB, Meltaer-Broday S. A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression on a specialized perinatal psychiatry inpatient unit. Arch Womens Ment Health. 2012;2:59–65.Google Scholar