Biofeedback Therapy for Migraines

Biofeedback (BFB) therapy is a technique used to help individuals become conscious of otherwise unconscious body processes through conveying information about blood pressure, heart rate, skin temperature, sweating and muscle tension. Patients use their minds to control their bodies. This therapy may effectively treat migraine headaches, a new study suggests.

Researchers from Philipps-University of Marburg in Germany conducted a meta-analysis examining the efficacy of BFB in treating migraine. A computerized literature search of the databases Medline, PsycInfo, Psyndex and the Cochrane library, as well as a hand search, identified 86 outcome studies. A total of 55 studies, including randomized controlled trials and pre-post trials, met inclusion criteria and were integrated.

Researchers found that a medium effect size resulted for all BFB interventions and proved stable over an average follow-up phase of 17 months. Also, BFB was more effective than control conditions. Frequency of migraine attacks and perceived self-efficacy demonstrated the strongest improvements. Blood-volume-pulse feedback yielded higher effect sizes than peripheral skin temperature feedback and electromyography feedback.

Moderator analyses revealed BFB in combination with home training was more effective than therapies without home training. The influence of the meta-analytical methods on the effect sizes was systematically explored, and the results proved to be robust across different methods of effect size calculation.

Researchers found no substantial relationship between the validity of the integrated studies and the direct treatment effects. Finally, an intention-to-treat analysis showed that the treatment effects remained stable, even when dropouts were considered as non-responders.

Biofeedback has been shown to be helpful in treating a variety of medical conditions including asthma, Raynaud's disease, irritable bowel syndrome (IBS), hot flashes, incontinence, headaches, irregular heartbeats, high blood pressure, epilepsy and nausea and vomiting associated with chemotherapy. Other common uses include the treatment of stress and stress-related conditions such as anxiety and insomnia. Interest in BFB has fluctuated since its development in the 1960s. Today, the therapy is regaining popularity, possibly because of the general increase of interest in complementary and alternative medicine (CAM) modalities.