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Pediatrics. 2016 Aug;138(2). pii: e20160675. doi: 10.1542/peds.2016-0675.

Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis.

Author information

1
Department of Neuroscience, NTNU Norwegian University of Science and Technology, Trondheim, Norway;
2
Department of Health and Rehabilitation/Physiotherapy, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;
3
Duke Evidence Synthesis Group, Duke Clinical Research Institute, Durham, North Carolina; Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina;
4
Section for Medicine, NTNU University Library, NTNU Norwegian University of Science and Technology, Trondheim, Norway; and.
5
Department of Neuroscience, NTNU Norwegian University of Science and Technology, Trondheim, Norway; Norwegian Advisory Unit on Headaches, St Olavs Hospital, Trondheim, Norway.

Abstract

CONTEXT:

Migraine is a common problem in children and adolescents, but few satisfactory prophylactic treatments exist.

OBJECTIVE:

Our goal was to investigate the pooled evidence for the effectiveness of using biofeedback to reduce childhood migraine.

DATA SOURCES:

A systematic search was conducted across the databases Medline, Embase, CENTRAL, CINAHL, and PsychINFO.

STUDY SELECTION:

Prospective, randomized controlled trials of biofeedback for migraine among children and adolescents were located in the search.

DATA EXTRACTION:

Data on reduction of mean attack frequency and a series of secondary outcomes, including adverse events, were extracted. Risk of bias was also assessed.

RESULTS:

Forest plots were created by using a fixed effects model, and mean differences were reported. Five studies with a total of 137 participants met the inclusion criteria. Biofeedback reduced migraine frequency (mean difference, -1.97 [95% confidence interval (CI), -2.72 to -1.21]; P < .00001), attack duration (mean difference, -3.94 [95% CI, -5.57 to -2.31]; P < .00001), and headache intensity (mean difference, -1.77 [95% CI, -2.42 to -1.11]; P < .00001) compared with a waiting-list control. Biofeedback demonstrated no adjuvant effect when combined with other behavioral treatment; neither did it have significant advantages over active treatment. Only 40% of bias judgments were deemed as "low" risk.

LIMITATIONS:

Methodologic issues hampered the meta-analyses. Only a few studies were possible to include, and they suffered from incomplete reporting of data and risk of bias.

CONCLUSIONS:

Biofeedback seems to be an effective intervention for pediatric migraine, but in light of the limitations, further investigation is needed to increase our confidence in the estimate.

PMID:
27462067
DOI:
10.1542/peds.2016-0675
[Indexed for MEDLINE]
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