Mindfulness-based cognitive therapy for migraine may reduce disability

PHILADELPHIA — Patients who received mindfulness-based cognitive therapy experienced reduced levels of disability compared with patients who did not, according to a study presented at the American Headache Society Annual Meeting.

“More than 50% of adults with migraine and severe headache use complimentary and integrative health strategies for headache management,” Elizabeth Seng, PhD, assistant professor of Yeshiva University and research assistant professor in the department of neurology at Albert Einstein College of Medicine, said. “But we don’t know much about if, or how these strategies work.”

To determine if mindfulness-based cognitive therapy affected disability in migraine, Seng and colleagues evaluated patients with migraine recruited through referrals and ads in the New York City area. After patients completed 30-day baseline diaries, those with migraine diagnosis and at least 6 headache days per month who were aged 18 to 65 years old were included in the study.

The Henry Ford Disability Inventory was used to assess perceived disability and Migraine Disability Assessment Scale scores were used to assess functional disability at each month of the 4-month treatment period. Researchers also assessed changes in the number of headache days and pain intensity from the baseline.

A total of 166 patients were assessed for eligibility. Of those, 31 with chronic migraine and 29 with episodic migraine were randomly assigned to receive 8 weeks of 75-minute mindfulness-based cognitive therapy sessions or wait listed and had treatment received treatment as usual.

Among participants, 51.4% met the criteria for chronic migraine. Patients who received mindfulness-based cognitive therapy tailored for migraine reported larger decreases in Henry Ford Disability Inventory compared with those who received usual care (P < .001).

The predicted proportion of individuals who reported severe disability on the Migraine Disability Assessment Scale decreased by 21.6% from the month 0 to month 4 (P <.001) in both groups.

Researchers did not find statistically significant changes in the number of headache days or in pain intensity after treatment.

“The overarching story is that [mindfulness-based cognitive therapy] reduced headache disability but not days or pain intensity,” Seng said.

“The fact that people can improve the way people live in their daily life, even with the same amount of headache days and the same pain intensity, is remarkable,” she continued.

Seng’s study was the winner of the first annual American Headache Society Early Career Lecture Award. The award is given to the best paper on headache, head or face pain, or the nature of pain submitted by an individual who completed medical school within the last 10 years. – by Erin Michael

Reference: Seng E, et al. Does mindfulness-based cognitive therapy for migraine reduce migraine-related disability? Results from a phase 2b pilot randomized clinical trial. Presented at: American Headache Society Annual Scientific Meeting; July 11-14, 2019; Philadelphia.

Disclosures: Seng reports no relevant financial disclosures.