Meditation for Migraines: A Pilot Randomized Controlled Trial

Rebecca Erwin Wells MD, MPH; Rebecca Burch MD; Randall H. Paulsen MD; Peter M. Wayne PhD; Timothy T. Houle PhD; Elizabeth Loder MD, MPH

Disclosures

Headache. 2014;54(9):1484-1495. 

In This Article

Results

Nineteen migraineurs were randomized to either MBSR (n = 10) or usual care (n = 9) (see Figure) and results were analyzed intention-to-treat. Baseline characteristics of participants are shown in Table 1. MBSR was safe (no adverse events), with 0% dropout and excellent adherence (daily meditation average: 34 ± 11 minutes (range 16–50 minutes/day). Median class attendance from 9 classes (including retreat day) was 8 (range [3, 9]); average class attendance was 6.7 ± 2.5. Most participants in the trial were referred by Headache clinicians at the Graham Headache Center (70% in MBSR group, 67% in control group) or by another headache provider (10% in MBSR group, 22% in control group); very few learned of the study via flyer (20% in MBSR group and 11% in control group), see Table 1. Table 2 summarizes changes for headache characteristics. Despite inadequate power due to small sample size, from baseline to initial follow-up, compared to control, MBSR participants had 1.4 fewer migraines/month (3.5 to 1.0 migraines/month in MBSR vs 1.2 to 0 migraines/month in control, 95% confidence interval CI [−4.6, 1.8], P = .38). The severity and duration of all headaches decreased in the MBSR group (−1.3 points/headache on 0–10 scale [−2.3, 0.09], P = .053, which did not reach statistical significance, and 2.9 fewer hours per headache [−4.6, −0.02], P = .043). Table 3 summarizes changes for standardized instruments. Disability decreased in MBSR vs control on HIT-6 (−4.8, [−11.0, −1.0], P = .043) and 1-month MIDAS (−12.6 [−22.0, −1.0], P = .017). Lower HIT-6 and MIDAS scores reflect less headache impact and disability, and a change of 2.3 points on HIT-6 reflects the minimum important difference that reflects meaningful clinical change.[42] Self-efficacy and mindfulness also increased (+13.2 [1.0, 30.0], P = .035 and +13.1 [3.0, 26.0], P = .035, respectively). The effect sizes for migraine-specific quality of life, anxiety, and perceived stress also showed improvement. Effect sizes persisted in all outcomes at final follow-up.

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