Improving Migraine-Related Disability With Mindfulness-Based Cognitive Therapy

Future research should evaluate the difference in mechanisms and effect moderators between more traditional empirically supported behavioral migraine treatments and mindfulness-based cognitive therapy for migraine.

According to study results published in Headache, mindfulness-based cognitive therapy might effectively reduce headache-related disability and attack-level migraine-related disability in people with episodic or chronic migraine.

To evaluate whether patients with chronic or episodic migraine can benefit from mindfulness meditation and cognitive-behavior skills, researchers randomly assigned 60 patients with migraine (average age, 40.1 years; 6-30 headache days/month) to 8 approximately once-weekly mindfulness-based cognitive therapy sessions (n=31) or 8 weeks of waitlist/treatment as usual (n=29).

The researchers assessed each patient for change from baseline to month 4 in the headache disability inventory and the Migraine Disability Assessment. They also monitored headache days/month, average headache attack pain intensity, and attack-level migraine-related disability via headache diaries that patients kept in the 30 days before and 30 days after testing.

Average baseline headache disability inventory score was 51.4 (moderate), and 83.3% of patients were experiencing severe disability according to Migraine Disability Assessment scores. Participants reported an average of 16.0 headache days per month, with moderate average headache attack pain intensity (1.7 on a 4-point scale). Overall, patients experienced average daily disability of 3.1/10.

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At month 4, the proportion of patients from the total population who experienced severe disability dropped from 88.3% to 66.7% (P <.001). Compared with patients in the control group, those who completed mindfulness-based cognitive therapy saw significantly greater average reductions from baseline to month 4 on the headache disability inventory (−0.2; P <.001). Furthermore, whereas control patients saw an average increase of 0.3 points on the Migraine Disability Index, intervention patients saw an average decrease of 0.6 points (P =.007).

Limitations to this study included the self-reported nature of collected data and a heterogeneous population.

“Individual mindfulness-based cognitive therapy demonstrated efficacy to reduce headache-related disability and attack-level migraine-related disability,” the authors concluded. “In addition, participants generally adhered to treatment and reported a favorable attitude toward the experience. [Mindfulness-based cognitive therapy] is a promising emerging treatment for addressing migraine-related disability.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Seng EK, Singer AB, Metts C, et al. Does mindfulness-based cognitive therapy for migraine reduce migraine-related disability in people with episodic and chronic migraine? A phase 2b pilot randomized clinical trial. Headache. 2019;69(9):1448-1467.