Table 1:
Clinical Research Studies Evaluating Mindfulness-Based Interventions in Migraine
| Article & Location & Yates Quality Rating Scale (YQRS) | Headache Type | Study Characteristics | Results | Strengths Limitations |
|---|---|---|---|---|
| Wells et al.[83] 2014 Boston, MA YQRS=31 |
Episodic Migraine, 4–14 migraine days/ month |
Intervention: MBSR as adjunctive to pharmacological treatments Control group: Wait-list Sample Size: n=19 Average age: 46 |
• Feasible, acceptable • Primary outcome (HA frequency): • Both groups decreased HA frequency, no statistical difference • Positive secondary outcomes-MBSR group improved: • Migraine duration • Disability • Self-efficacy • Mindfulness |
Strengths • Standardized MBSR program • Participants randomized & blinded to control group assignment • HA diaries used • Primary & secondary outcomes clearly defined Limitations • Small sample size (pilot study), underpowered • No active control group |
| Seng et al.[79] 2019 Bronx & Manhattan, NY YQRS=31 |
Migraine, 6–30 headache days/ month |
Intervention: MBCT-Individual therapist Control Group: Waitlist/ Treatment as usual Sample Size:n=60 Average Age: 40 |
• Primary outcome (disability) positive: MBCT group had improvements vs. control: • Migraine related disability • Attack level disability • Secondary outcomes: no improvements in HA frequency or intensity • Both groups had improvements in severe disability ratings |
Strengths • Well-defined primary outcome of disability • Treatment fidelity measures assessed & described • HA diaries used • Primary & secondary outcomes clearly defined Limitations • No active control group • Study stopped prior to reaching recruitment goals • Mixed migraine population of both episodic and chronic migraine |
| Day et al.[85] 2014 Northport & Tuscaloosa, AL YQRS=29 |
Any primary headache (migraine, tension-type, cluster, etc.) |
Intervention: MBCT-group based Control Group: Delayed treatment Sample Size: n=36 Average Age: 42 |
• Feasible, acceptable, tolerable • Primary outcomes (HA frequency, duration, intensity): • Both groups decreased HA frequency, no statistical difference • Secondary outcomes: MBCT group-improved: • Self-efficacy • Chronic pain acceptance |
Strengths • 1st study of MBCT in headache • Primary & secondary outcomes clearly defined Limitations • Un-blinded • Heterogeneous headache population (any primary headache condition) |
| Simshäuser et al.[82] 2019 Freiburg, Germany YQRS=26 |
Episodic migraine, 2–15 migraines/ month |
Intervention: MBSR Control Group: HA education + Behavioral (3 sessions) Sample Size: n=62 Average Age: 44 |
• Primary outcome (HA frequency): • Both groups decreased HA frequency, no statistical difference • Secondary outcomes: MBSR had greater improvements than control group in: • Psychological symptoms • Anxiety • Self-efficacy • Sensory component of pain |
Strengths • Standardized MBSR program • Active control group • HA diaries used • 12 month follow-up • Primary & secondary outcomes clearly defined Limitations • Pilot study • High dropout rates • Control group may have been too active • 19% of MBSR participants had baseline HA frequency <2, no room for improvement |
| Tavallaei et al.[86] 2018 Tehran, Iran YQRS=19 |
Tension-type or migraine headache |
Intervention: MBSR “internet-based bibliotherapy” Control Group: Treatment as usual Sample Size: n=30 Average Age: 34 |
• MBSR group had improvements vs. control: • Pain intensity • Disability • Distress • Mindfulness • Emotional pain |
Strengths • Unique self-guided approach Limitations • Intervention not clearly defined • No HA outcomes measured with daily diaries • Heterogeneous headache population (tension-type & migraine) • Primary & secondary outcomes not clearly defined |
| Bakhshani et al.[87] 2015 Zahedan, Iran YQRS=18 |
Chronic migraine and chronic tension-type headache |
Intervention: MBSR as adjunctive to pharmacological treatments Control Group: Usual care Sample Size: n=40 Average Age:31 |
• MBSR group had improvements vs. control: • Pain intensity • Short form (SF)-36 |
Strengths • Chronic headache patients Limitations • Heterogeneous HA population (migraine & tension-type) • No HA outcomes measured with daily diaries • Primary & secondary outcomes not clearly defined |
| Hess et al. [88] 2015 Salt Lake City, UT YQRS=18 |
“Recurrent headache” 4+/month |
Intervention: adapted MBSR Control Group: No control group Sample Size: n=20 Average Age:14 |
• Primary outcome: Safe, feasible • Secondary outcomes: MBSR participants (without a comparison) had: • Improvements in depression symptoms, pain withdrawal • Parents of participants reported improved quality of life |
Strengths • Study in adolescent females • Primary & secondary outcomes clearly defined Limitations • No control group • Non-randomized • High dropout rates • HA outcomes not analyzed • Heterogeneous headache population (“recurrent headache”) • All females |
| Grazzi et al.[80] 2017 Milan, Italy YQRS=17 |
Chronic migraine-medication overuse headache |
Intervention: Mindfulness training Control Group: Pharmacological treatment Sample Size: n=44 Average Age: 45 |
• Primary outcomes (headache frequency, use of acute medications), both groups had decreases in: • HA frequency • Medication usage • Secondary outcomes, both groups improved: • Disability • Depression |
Strengths • Clinically applicable • Mindfulness compared to pharmacological treatment • HA diaries used • 12 month follow-up Limitations • Non-randomized: participants non-blinded & chose treatment assignment |