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May 13, 2020
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Yoga may be ‘game changer’ for patients with migraine

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Yoga as an add-on therapy was superior to medical therapy alone for adults with migraine, according to a prospective, randomized, open-label trial published in Neurology, the medical journal of the American Academy of Neurology.

“Only about half of patients with migraine have clinically meaningful responses with medications and preventive drug treatments; about 10% discontinue medications due to adverse events, and around half of the patients report dissatisfaction with their current treatment strategies,” Anand Kumar, MD, DM, of the department of neurology at the All India Institute of Medical Sciences in New Delhi, and colleagues wrote. “The shortcomings of existing treatment options substantiate the great opportunity for exploring additional migraine treatment strategies.”

Researchers randomly assigned 160 adults with episodic migraine with or without aura in a 1:1 ratio to a combination of conventional medical therapy and yoga or only yoga. Patients had between four and 14 headaches monthly at baseline and had not changed their migraine medication for 3 months and their dose for at least 1 month before study enrollment. Yoga participants engaged in three supervised sessions weekly for 1 month at a medical and research center, then five sessions weekly in their homes for the remaining 2 months of the study.

For 3 months, participants kept diaries about their headache duration, Headache Impact Test scores, any associated sickness such as nausea or vomiting, site of headache, triggering activities or events, and, when applicable, rescue medications and adverse events related to their use. Each participant was contacted monthly for the duration of the study by an independent masked assessor.

Reference. Kumar A, et al. Neurology. 2020;doi:10.1212/WNL.0000000000009473.

Researchers found that compared with medical therapy, those who received conventional medical therapy and participated in yoga showed a significant mean delta value reduction in headache frequency (delta difference = 3.53; 95% CI, 2.52-4.54), headache intensity (delta difference = 1.31; 95% CI, 0.6-2.01), Headache Impact Test score (delta difference = 8; 95% CI, 4.78-11.22), Migraine Disability Assessment questionnaire score (delta difference = 7.85; 95% CI, 4.98-10.97) and pill count (delta difference = 2.28; 95% CI, 1.06-3.51).

“Our results show that yoga can reduce not just the pain, but also the treatment cost of migraines,” Rohit Bhatia, MD, DM, DNB, of the of the department of neurology at the All India Institute of Medical Sciences, said in a press release. “That can be a real game changer, especially for people who struggle to afford their medication.” – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.