Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study
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RESEARCH
Open Access
Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study Deborah A Stokes1*, Martha S Lappin2
Abstract Background: Traditional peripheral biofeedback has grade A evidence for effectively treating migraines. Two newer forms of neurobiofeedback, EEG biofeedback and hemoencephalography biofeedback were combined with thermal handwarming biofeedback to treat 37 migraineurs in a clinical outpatient setting. Methods: 37 migraine patients underwent an average of 40 neurofeedback sessions combined with thermal biofeedback in an outpatient biofeedback clinic. All patients were on at least one type of medication for migraine; preventive, abortive or rescue. Patients kept daily headache diaries a minimum of two weeks prior to treatment and throughout treatment showing symptom frequency, severity, duration and medications used. Treatments were conducted an average of three times weekly over an average span of 6 months. Headache diaries were examined after treatment and a formal interview was conducted. After an average of 14.5 months following treatment, a formal interview was conducted in order to ascertain duration of treatment effects. Results: Of the 37 migraine patients treated, 26 patients or 70% experienced at least a 50% reduction in the frequency of their headaches which was sustained on average 14.5 months after treatments were discontinued. Conclusions: All combined neuro and biofeedback interventions were effective in reducing the frequency of migraines with clients using medication resulting in a more favorable outcome (70% experiencing at least a 50% reduction in headaches) than just medications alone (50% experience a 50% reduction) and that the effect size of our study involving three different types of biofeedback for migraine (1.09) was more robust than effect size of combined studies on thermal biofeedback alone for migraine (.5). These non-invasive interventions may show promise for treating treatment-refractory migraine and for preventing the progression from episodic to chronic migraine.
Background Migraine is a common, disabling and often progressive disorder characterized by increased excitability of the central nervous system [1,2]. It occurs in 18% of women and 6% of men in the US with peak prevalence in individuals between the ages of 25 and 55 [3]. Economic burden of migraine in the US is estimated to be approximately 13 billion annually [4]. Biofeedback is a common intervention in pain management. For migraine treatment, the most frequently used biofeedback methods have been peripheral skin temperature biofeedback, blood- volume-pulse and electromyography feedback [5]. In a recent meta-analysis involving biofeedback for the treatment of migraine, Grade A * Correspondence: [email protected] 1 The Better Brain Center, Inc, 2121 Eisenhower Ave Suite 604 Alexandria, VA 22314, USA
evidence [6] was found for the efficacy of the above methods which proved stable over a 17 month followup phase [5]. Numerous studies explore peripheral biofeedback [5] but scant
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