Migraine headaches are associated with increased impulsivity, which can exacerbate headache frequency.

This randomized controlled trial investigated the effectiveness of transcranial direct current stimulation (tDCS), acceptance and commitment therapy (ACT), and their combination in reducing impulsivity among 96 women (mean age = 36.15, SD = 6.14) with migraines, recruited from private neurology clinics in Tehran, Iran. Participants were assigned to tDCS (10 sessions), ACT (8 online group sessions), tDCS + ACT (18 sessions), or a control group with no intervention. Impulsivity was measured using the Barratt Impulsivity Scale at baseline, post-intervention, and three-month follow-up.

All interventions significantly reduced impulsivity scores. The combined tDCS + ACT intervention showed the largest effect sizes across overall impulsivity (OI: η ²  = 0.528, P = 0.001) and subscales: AI: η ²  = 0.432, P = 0.001, NI: η ²  = 0.381, P = 0.001), and MI: η ²  = 0.429, P = 0.001. The combined intervention outperformed tDCS alone in reducing AI (P = 0.001), NI (P = 0.002), MI (P = 0.006), and OI (P = 0.001). ACT alone was more effective than tDCS in reducing AI, NI, and OI (P  <  0.005). The combined therapy resulted in an average 23-point reduction in OI scores from baseline to follow-up.

Limitations include a small sample size, short follow-up period, and reliance on self-reported measures. The findings suggest that ACT, tDCS, and their combination effectively reduce impulsivity in women with migraines, with the combined approach offering superior benefits. This reduction may improve emotional regulation and potentially decrease migraine frequency and severity. Larger studies with extended follow-up are needed to confirm these preliminary results.