Comparison of Four Biofeedback Treatments for Migraine Headache: Physiological and Headache Variables*

Abstract

Forty-two migraine headache patients participated in an appraisal of biofeedback for differential finger warming--forehead cooling, frontalis EMG relaxation, alpha enhancement and vasoconstriction of the temporal scalp arteries. All patients provided 8 weeks of baseline charting of headache and then received 24 training sessions in one of the above conditions. Headache charting continued throughout training and for 8 months posttraining. During the training period measures were made of each biofeedback variable plus forehead temperature, heart rate, skin conductance, and finger pulse amplitude. Analyses revealed that all groups had a significant reduction in number of headaches per week with no change in intensity, disability or length of headache. Physiological changes were consistently small and unrelated to headache outcome. A nonspecific effect for biofeedback is suggested with the likely candidates being a relaxation phenomenon or a cognitive explanation based upon perceived control.

Classification of Migraine and Tension Headache from a Survey of 10,000 Headache Diaries

“…4 All patients had been diagnosed as having a chronic migraine headache condition or mixed migraine-tension headaches. Patient selection has been described elsewhere in detail.…”

Neuromodulatory treatments for chronic pain: efficacy and mechanisms

“…101 Another study found that patients who received any one of four different biofeedback interventions (including one designed to increase alpha power) reported significant reductions in headache activity. 102 One study comparing two biofeedback treatments (one to increase hand warmth and the second to increase alpha power) and a self-hypnosis training intervention in a sample of 33 individuals with migraine headache found positive effects for all three treatments that did not differ significantly between conditions. 103 These preliminary findings suggest that neurofeedback—specifically, alpha enhancement neurofeedback—has the potential to reduce headache frequency and severity, and that this approach might have similar efficacy to other forms of biofeedback (or hypnosis) for the treatment of headache pain.…”

Neuromodulatory Approaches for Chronic Pain Management: Research Findings and Clinical Implications

“…Moreover, although participants in both of the neurofeedback conditions showed an increase in alpha output, those who received both hypnosis and neurofeedback demonstrated the most increase in alpha output over the course of treatment, whereas those who received neurofeedback training only demonstrated the most increase in pre-to postsession alpha output. Cohen, McArthur, and Rickles (1980) assigned 42 patients presenting with migraine headache to 24 sessions (over the course of 8-10 weeks) of one of four biofeedback conditions: (a) forehead cooling=hand warming, (b) frontalis EMG reduction, (c) temporal artery vasoconstriction, and (d) alpha enhancement. Alpha EEG activity (8-13 Hz) was measured from O2 and P4, with feedback provided as tone-off (alpha above threshold with the threshold adjusted according to performance) or tone-on (alpha below threshold).…”

“…Although controlled trials comparing neurofeedback to no treatment (standard care) or placebo treatment have not yet been performed, at least three studies have compared neurofeedback to other established treatments (e.g., hand-warming biofeedback, EMG biofeedback, hypnotic analgesia; Andreychuk & Skriver, 1975;Cohen et al, 1980;Melzack & Perry, 1975). In each of these studies, the neurofeedback intervention was shown to be at least as as effective as the comparison treatments.…”