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

Licia Grazzi, Eleonora Grignani, Alberto Raggi, Paul Rizzoli, Erika Guastafierro

Journal: International journal of environmental research and public health 2021;18(22):11739

PMID: 34831494

Plain Language Summary

Chronic migraine (CM) is a highly disabling condition in both adults and adolescents. Behavioural approaches are considered helpful for younger patients with high frequency episodic migraine (HFEM) and CM to manage pain, to reduce the number of analgesics and to reduce the use of preventive medications. The main aim of this study was to examine the effect of a mindfulness-based intervention in adolescents with CM or HFEM. Secondary aims include the evaluation of mindfulness effects on medication intake, disability, anxiety, depression, catastrophizing, and caregivers’ burden. This study is a single-arm open-label study which enrolled 37 adolescents aged 12–18 years. After enrolment, patients were followed up for 12 months, with visits at 6 and 12 months (in which patients filled-in the whole protocol), and a phone contact at 3 months. Results indicate that participants who attended the mindfulness-based meditation program and were not prescribed any pharmacological prophylaxis, underwent an improvement of both headache frequency and medication intake at both 6- and 12-months follow-up. They also improved in catastrophizing, symptoms of depression, trait anxiety and disability. Authors conclude that group-based mindfulness intervention merits attention for the management of adolescents with CM and HFEM without aura.

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, < 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, < 0.001), disability (F = 3.8, = 0.027), trait anxiety (F = 5.1, = 0.009), symptoms of depression (F = 9.5, < 0.001), and catastrophizing (F = 23.6, < 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.

Address: Dipartimento Neuroalgologia Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy.; UO Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy.; John Graham Headache Center, Brigham and Women's Faulkner Hospital, Harvard Medical School, Boston, MA 02115, USA.

DOI: 10.3390/ijerph182211739