Behavioral Interventions for Migraine Prevention

Target audience and instructional level of this course: Intermediate

There is no known conflict of interest or commercial support related to this CE program.

TRAINING

Course Description

This article reviews the effectiveness of behavioral interventions, including CBT, biofeedback, relaxation training, and mindfulness-based therapies, for migraine prevention in adults and adolescents. It highlights modest benefits in reducing migraine frequency and disability, with limited evidence for pediatric populations. Mindfulness-based stress reduction may enhance quality of life compared to education, while behavioral sleep modification shows potential for chronic migraines. Adverse effects are rarely reported, and evidence for individual components is inconclusive due to study limitations. The review emphasizes the need for standardized methodologies and further research to evaluate behavioral strategies alongside pharmacologic treatments for migraine management.

Learning Objectives

After completing this training the professional will be able to:

1. Define and describe the role of behavioral interventions, such as CBT, biofeedback, and relaxation training, in reducing migraine frequency and disability.
   Outline and summarize the comparative effectiveness of mindfulness-based stress reduction and other behavioral therapies versus pharmacologic treatments for migraine prevention.
2. Identify the limitations and gaps in the existing evidence on behavioral interventions for migraines, particularly in pediatric and adolescent populations.
3. Describe the potential benefits of integrating biopsychosocial factors into migraine prevention strategies and their implications for future research.

Author(s)/Reference(s)

ECRI-Penn Evidence-based Practice Center Plymouth Meeting, PA, and Philadelphia, PA
Investigators: Jonathan R. Treadwell, Ph.D.a Amy Y. Tsou, M.D.a Benjamin Rouse, M.S.a Ilya Ivlev, M.D., Ph.D.a Julie Fricke, Ph.D.b Dawn Buse, Ph.D.c Scott W. Powers, Ph.D.d,e,f Mia Minen, M.D.g Christina L. Szperka, M.D., M.S.C.E.h Nikhil K. Mull, M.D.b,i
ECRI, Plymouth Meeting, PA
Penn Medicine Center for Evidence-based Practice, Philadelphia, PA
Department of Neurology, Albert Einstein College of Medicine, New York, NY
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
Headache Center, Cincinnati Children's Hospital, Cincinnati, OH
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, OH
New York University Departments of Neurology and Population Health, NYU Langone Health, New York, NY
Children's Hospital of Philadelphia & Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
Division of Hospital Medicine, University of Pennsylvania, Philadelphia, PA