Behavioral Interventions for Migraine - 26/09/19

Doi : 10.1016/j.ncl.2019.07.003

Andrea Pérez-Muñoz, BA ^a,^⁎ , Dawn C. Buse, PhD ^b,^c , Frank Andrasik, PhD ^a
^a Department of Psychology, University of Memphis, 400 Innovation Drive, Memphis, TN 38152, USA
^b Department of Neurology, Albert Einstein College of Medicine of Yeshiva University, 1250 Waters Place, Bronx, NY 10461, USA
^c Clinical Health Psychology Doctoral Program, Ferkauf Graduate School of Psychology of Yeshiva University, 1165 Morris Park Avenue, Bronx, NY, USA

^∗Corresponding author.

Résumé

Biobehavioral interventions for migraine incorporate both physiologic and psychological factors. This article details treatments for migraine management and prevention, ranging from traditional to newly emerging interventions. Similarly, this article reviews key person-related factors that may affect migraine prevalence and management. Aspects related to patient-physician relationships and communication are also reviewed. Research involving childhood and adolescent migraine is reviewed, and special considerations regarding this population are summarized. Clinical trials and other studies have provided evidence that these behavioral interventions, when combined with pharmacotherapy, show a marked improvement in primary treatment outcomes, such as a decrease in headache frequency and duration.

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Keywords : Migraine, Headache, Biofeedback, Cognitive behavior therapy (CBT), Relaxation training (RT), Behavioral medicine, Biobehavioral interventions, Behavioral management

Plan

Key points

Introduction

Migraine epidemiology, burden, and impact

Behavioral interventions: the mainstay or long-standing approaches

Biofeedback

Relaxation training

Cognitive behavioral therapy

Patient education

Behavioral interventions with children and adolescents with migraine

Alternative delivery modalities

Emerging approaches: mindfulness and acceptance and commitment therapy–based interventions

A nod to the future: heart rate variability and neurofeedback

Treatment adherence, motivation, and referrals

Psychological comorbidities

Summary

Disclosures: D.C. Buse has received grant support and honoraria from Allergan, Avanir, Amgen, Biohaven, Lilly, Teva, and Promius. She is on the editorial board of Current Pain and Headache Reports. F. Andrasik serves as Associate Editor for Cephalalgia.