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Expert Rev Neurother. 2020 Jan 14. doi: 10.1080/14737175.2020.1715212. [Epub ahead of print]

Mindfulness in migraine.

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Comprehensive Headache Program, Clinical Research, Center for Integrative Medicine, Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Boston, MA, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
Center for Integrative Pain NeuroImaging (CiPNI), Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Center for Mindfulness and Compassion, Addictions, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.


Introduction: Migraine is the second leading cause of disability worldwide, yet many patients are unable to tolerate, benefit from, or afford pharmacological treatment options. Non-pharmacological migraine therapies exist, especially to reduce opioid use, which represents a significant unmet need. Mindfulness-based interventions (MBI) have potential as a non-pharmacological treatment for migraine, primarily through the development of flexible attentional capacity across sensory, cognitive, and emotional experiences.Areas covered: The authors review efficacy and potential mechanisms of MBIs for migraine, including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).Expert opinion: While most mindfulness research studies for migraine to date have been pilot trials, which are small and/or lacked rigor, initial evidence suggests there may be improvements in overall headache-related disability and psychological well-being. Many research questions remain to help target the treatment to patients most likely to benefit, including the ideal dosage, duration, delivery method, responder characteristics, and potential mechanisms and biomarkers. A realistic understanding of these factors is important for patients, providers, and the media. Mindfulness will not "cure" migraine; however, mindfulness may be an important tool as part of a comprehensive treatment approach to help patients "mindfully" engage in valued life activities.


complementary and alternative medicine; integrative medicine; meditation; migraine; mind-body medicine; mindfulness; mindfulness-based cognitive therapy; mindfulness-based intervention; mindfulness-based stress reduction

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