Effect of a Mindfulness-Based Intervention for Chronic Migraine and High Frequency Episodic Migraine in Adolescents: A Pilot Single-Arm Open-Label Study

Abstract

In this single-arm pilot open-label study we examined the effect of a mindfulness-based intervention on reduction of headache frequency after 12 months in adolescents aged 12–18 with chronic or high-frequency migraine without aura. Adolescents were recruited at the headache center of the C. Besta Neurological Institute and followed-up for 12 months. The mindfulness-based intervention was delivered in small groups and consisted of six weekly group sessions of guided meditation, and one booster session 15 days after. Patients filled in questionnaires assessing headache frequency (primary endpoint), medication intake, disability, anxiety, depression, catastrophizing, and caregivers’ burden. Within-person ANOVA was used to address variation of endpoints over time. Thirty-five out of 37 patients completed the study for primary endpoints, and 33 for secondary endpoints. Headache frequency dropped from 21.3 (95% CI 18.5; 24.1) to 9.6 (95% CI 6.1; 13.1) days per month at 12 months (F = 30.5, p < 0.001); 23 patients out of 35 (65.7%) achieved a headache frequency reduction greater than or equal to 50%. Significant improvements were also reported for medication intake (F = 18.7, p < 0.001), disability (F = 3.8, p = 0.027), trait anxiety (F = 5.1, p = 0.009), symptoms of depression (F = 9.5, p < 0.001), and catastrophizing (F = 23.6, p < 0.001). In conclusions, our study shows a reduction of headache attacks in adolescents who follow a mindfulness-based program, suggesting benefit of this nonpharmacological approach.

Management of Chronic Migraine in Children and Adolescents: Where are We in 2022?

“… 58 The evidence for ACT in the treatment of pediatric chronic pain is growing. 59 Two investigations of mindfulness-based interventions for chronic migraine in children and adolescents, including one recent open-label trial, have shown promising results in reducing migraine-related disability, 60 , 61 mirroring findings from trials of mindfulness-based interventions among adults with migraine. 62 , 63 …”

“…58 The evidence for ACT in the treatment of pediatric chronic pain is growing. 59 Two investigations of mindfulness-based interventions for chronic migraine in children and adolescents, including one recent open-label trial, have shown promising results in reducing migraine-related disability, 60,61 mirroring findings from trials of mindfulnessbased interventions among adults with migraine. 62,63 Other Preventive Treatment Options Clinical research efforts have been devoted to studying alternative treatments that reduce risks associated with traditional pill-based migraine therapies given current practice guidelines.…”

Mindfulness-based online intervention on mental health among undergraduate nursing students during coronavirus disease 2019 pandemic in Beijing, China: A randomized controlled trial

“…The intervention group received mindfulness training and the control group received health education unrelated to the content of the intervention material. Since the mindfulness course requires the students of intervention group to participate in and receive training, this study is an open-label trial, which does not involve blind methods ( 35 ). MLWC, the online intervention course used in this study, was developed by two Chinese psychiatrists, one of whom has been certified in the Training of Mindfulness Facilitation program at the Mindful Awareness Research Center of University of California, Los Angeles (UCLA).…”

From the New Diagnostic Criteria to COVID-19 Pandemic Passing Through the Placebo Effect. What Have We Learned in the Management of Pediatric Migrane Over the Past 5 Years?

“…Some pilot studies demonstrated the acceptability and feasibility of a mindfulness-based treatment for adolescents with recurrent headaches ( 59 , 60 ).…”

“…Evidence for the efficacy of psychological interventions for the treatment of headaches in youth has grown substantially over the past several decades (55,56,(58)(59)(60). There is a strong and growing body of evidence demonstrating the effectiveness of psychological approaches, primarily cognitivebehavioral therapy (CBT), for treating migraine in children and adolescents (37,38,54,55).…”