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

Mindfulness in migraine.

Author information

1
Comprehensive Headache Program, Clinical Research, Center for Integrative Medicine, Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA.
2
Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
3
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Boston, MA, USA.
4
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
5
Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA.
6
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
7
Center for Integrative Pain NeuroImaging (CiPNI), Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
8
Center for Mindfulness and Compassion, Addictions, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.

Abstract

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.

KEYWORDS:

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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