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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 1/2013

01-01-2013 | Chronic Daily Headache (SJ Wang, Section Editor)

Behavioral Therapy for Chronic Migraine

Authors: Francesca Pistoia, Simona Sacco, Antonio Carolei

Published in: Current Pain and Headache Reports | Issue 1/2013

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Abstract

Chronic migraine is a disabling condition which affects a considerable proportion of patients. Several risk factors and lifestyle habits contribute to the transformation of migraine into a chronic form. Behavioral treatments, including relaxation, biofeedback, and cognitive behavioral therapy reduce the risk of episodic into chronic migraine transformation, thus restraining the headache-related disability. The rationale of behavioral therapies is that a medical problem should be recognized and thoroughly examined by the patient to be successfully managed. Being aware of factors which precipitate or aggravate migraine allows patients to progressively modulate the frequency and duration of their attacks. Similarly, the acquisition of healthy habits improves the quality of life and the subjective well-being of patients and contributes to breaking the vicious cycle that leads to migraine chronification. The highest level of care is achieved when behavioral therapies are integrated with other treatments, including physical and pharmacological interventions.
Literature
1.
Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press; 1994.
2.
• Von Korff M, Dunn KM. Chronic pain reconsidered. Pain. 2008;138:267–76. This reference is of importance to understand the correct way to consider and diagnose chronic pain and to predict its clinic course.CrossRef
3.
Lipton RB. Chronic migraine, classification, differential diagnosis, and epidemiology. Headache. 2011;51:77–83.PubMedCrossRef
4.
Scher AI, Stewart WF, Lieberman J, Lipton RB. Prevalence of frequent headache in a population sample. Headache. 1998;38:497–506.PubMedCrossRef
5.
6.
Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24:9–160.
7.
•• Olesen J, Bousser MG, Diener HC, Dodick D, First M, Goadsby PJ, for the Headache Classification Committee, et al. New appendix criteria open for a broader concept of chronic migraine. Cephalalgia. 2006;26:742–6. This reference highlights recent revised criteria for the diagnosis of chronic migraine.PubMedCrossRef
8.
•• Bigal ME, Rapoport A, Sheftell F, Tepper S, Lipton R. The International Classification of Headache Disorders revised criteria for chronic migraine-field testing in a headache specialty clinic. Cephalalgia. 2007;27:230–4. This reference highlights the reliability of revised criteria for the diagnosis of chronic migraine.PubMedCrossRef
9.
Silberstein S, Diener HC, Lipton R, Goadsby P, Dodick D, Bussone G, et al. Epidemiology, risk factors, and treatment of chronic migraine: a focus on topiramate. Headache. 2008;48:1087–95.PubMedCrossRef
10.
Sacco S, Ricci S, Degan D, Carolei A. Migraine in women: the role of hormones and their impact on vascular diseases. J Headache Pain. 2012;13:177–89.PubMedCrossRef
11.
Gupta S, McCarson KE, Welch KM, Berman NE. Mechanisms of pain modulation by sex hormones in migraine. Headache. 2011;51:905–22.PubMedCrossRef
12.
Katsarava Z, Dzagnidze A, Kukava M, Mirvelashvili E, Djibuti M, Janelidze M, et al. Primary headache disorders in the Republic of Georgia: prevalence and risk factors. Neurology. 2009;73:1796–803.PubMedCrossRef
13.
Queiroz LP, Barea LM, Blank M. An epidemiological study of headache in Florianopolis, Brazil. Cephalalgia. 2006;26:122–6.PubMedCrossRef
14.
Atasoy HT, Unal AE, Atasoy N, Emre U, Sumer M. Low income and education levels may cause medication overuse and chronicity in migraine patients. Headache. 2005;45:25–31.PubMedCrossRef
15.
Theeler BJ, Flynn FG, Erickson JC. Chronic daily headache in U.S. soldiers after concussion. Headache. 2012;52:732–8.PubMedCrossRef
16.
Packard RC. Chronic post-traumatic headache: associations with mild traumatic brain injury, concussion, and post-concussive disorder. Curr Pain Headache Rep. 2008;12:67–73.PubMedCrossRef
17.
Sacco S, Ripa P, Carolei A. Migraine attributed to genetic disorder: proposal of a new category. Cephalalgia. 2011;31:760–2.PubMedCrossRef
18.
Serý O, Hrazdilová O, Matalová E, Sevcík P. Pain research update from a genetic point of view. Pain Pract. 2005;5:341–8.PubMedCrossRef
19.
Milde-Busch A, Blaschek A, Heinen F, Borggräfe I, Koerte I, Straube A, et al. Associations between stress and migraine and tension-type headache: results from a school-based study in adolescents from grammar schools in Germany. Cephalalgia. 2011;31:774–85.PubMedCrossRef
20.
Andress-Rothrock D, King W, Rothrock J. An analysis of migraine triggers in a clinic-based population. Headache. 2010;50:1366–70.PubMedCrossRef
21.
Brighina F, Fierro B. Cortical hypoactivity or reduced efficiency of cortical inhibition in migraine? Cephalalgia. 2007;27:187–8.PubMedCrossRef
22.
23.
Budhiraja R, Roth T, Hudgel DW, Budhiraja P, Drake CL. Prevalence and polysomnographic correlates of insomnia comorbid with medical disorders. Sleep. 2011;34:859–67.PubMed
24.
Le Grand SM, Patumraj S, Phansuwan-Pujito P, Srikiatkhachorn A. Melatonin inhibits cortical spreading depression-evoked trigeminal nociception. Neuroreport. 2006;17:1709–13.PubMedCrossRef
25.
Gagnier JJ. The therapeutic potential of melatonin in migraines and other headache types. Altern Med Rev. 2001;6:383–9.PubMed
26.
Brun J, Claustrat B, Saddier P, Chazot G. Nocturnal melatonin excretion is decreased in patients with migraine without aura attacks associated with menses. Cephalalgia. 1995;15:136–9.PubMedCrossRef
27.
Evans RW, Williams MA, Rapoport AM, Peterlin BL. The association of obesity with episodic and chronic migraine. Headache. 2012;52:663–71.PubMedCrossRef
28.
Bernecker C, Ragginer C, Fauler G, Horejsi R, Möller R, Zelzer S, et al. Oxidative stress is associated with migraine and migraine-related metabolic risk in females. Eur J Neurol. 2011;18:1233–9.PubMedCrossRef
29.
Kaleagasi H, Özgür E, Özge C, Özge A. Bronchial hyper-reactivity in migraine without aura: is it a new clue for inflammation? Headache. 2011;51:426–31.PubMedCrossRef
30.
Buse DC, Manack A, Serrano D, Turkel C, Lipton RB. Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers. J Neurol Neurosurg Psychiatry. 2010;81:428–32.PubMedCrossRef
31.
Sacco S, Ricci S, Carolei A. Migraine and vascular diseases: a review of the evidence and potential implications for management. Cephalalgia. 2012;32:785–95.PubMedCrossRef
32.
Sacco S, Carolei A. Oxidative stress: a bridge between migraine and cardiovascular disease? Eur J Neurol. 2011;18:1201–2.PubMedCrossRef
33.
Sacco S, Carolei A. Burden of atherosclerosis and risk of venous thromboembolism in patients with migraine. Neurology. 2009;72:2056–7.PubMedCrossRef
34.
• Sacco S, Cerone D, Carolei A. Comorbid neuropathologies in migraine: an update on cerebrovascular and cardiovascular aspects. J Headache Pain. 2008;9:237–48. This reference helps the physician to recognize the comorbidities of migraine and their influence on chronification.PubMedCrossRef
35.
Lipton RB, Stewart WF, Sawyer J, Edmeads JG. Clinical utility of an instrument assessing migraine disability: the migraine disability assessment (MIDAS) questionnaire. Headache. 2001;41:854–61.PubMed
36.
•• Andrasik F. Behavioral treatment of migraine: current status and future directions. Expert Rev Neurother. 2004;4:403–13. This review is of importance to identify the most recent studies about the characteristics and effectiveness of behavioral treatments.PubMedCrossRef
37.
Lipchik GL, Smitherman TA, Penzien DB, Holroyd KA. Basic principles and techniques of cognitive-behavioral therapies for comorbid psychiatric symptoms among headache patients. Headache. 2006;46:119–32.CrossRef
38.
Rama S. Portal to higher awareness: the science of breath. In: Rama S, Ballentine R, Hymes A, editors. Science of breath. A practical guide. Honesdale: Himalayan Institute Press; 1998. p. 72–112.
39.
Stoyva JM. Autogenic training and biofeedback combined: a reliable method for the induction of general relaxation. In: Basmajian JV, editor. Biofeedback: principle and practice for clinicians. 3rd ed. Baltimore: Williams & Wilkins; 1989. p. 169–85.
40.
41.
Lutz A, Slagter HA, Dunne JD, Davidson RJ. Attention regulation and monitoring in meditation. Trends Cogn Sci. 2008;12:163–9.PubMedCrossRef
42.
• Ciancarelli I, Tozzi-Ciancarelli MG, Spacca G, Di Massimo C, Carolei A. Relationship between biofeedback and oxidative stress in patients with chronic migraine. Cephalalgia. 2007;27:1136–41. This paper is of importance as it suggests a possible mechanism leading to the beneficial effect of biofeedback in patients with chronic migraine.PubMedCrossRef
43.
Ciancarelli I, Tozzi-Ciancarelli MG, Di Massimo C, Olivieri L, Carolei A. Preventive nonpharmacological treatment and nitric oxide in chronic migraine. J Headache Pain. 2005;6:341–2.PubMedCrossRef
44.
Friar LR, Beatty J. Migraine: management by trained control of vasoconstriction. J Consult Clin Psychol. 1976;44:46–53.PubMedCrossRef
45.
Kropp P, Siniatchkin M, Gerber WD. On the pathophysiology of migraine links for “empirically based treatment” with neurofeedback. Appl Psychophysiol Biofeedback. 2002;27:203–13.PubMedCrossRef
46.
Andrasik F, Gerber WD. Relaxation, biofeedback, and stress-coping therapies. In: Olesen J, Tfelt-Hansen P, Welch KMA, editors. The headaches. New York: Raven Press; 1993. p. 833–41.
47.
48.
Rains JC. Chronic headache and potentially modifiable risk factors: screening and behavioral management of sleep disorders. Headache. 2008;48:32–9.PubMedCrossRef
49.
Goslin RE, Gray RN, McCrory DC, et al. Behavioral and physical treatments for migraine headache. Rockville: Agency for Health Care Policy and Research; 1999.
50.
Wallasch TM, Angeli A, Kropp P. Outcomes of a headache-specific cross-sectional multidisciplinary treatment program. Headache. 2012;52:1094–105.PubMedCrossRef
51.
D’Souza PJ, Lumley MA, Kraft CA, Dooley JA. Relaxation training and written emotional disclosure for tension or migraine headaches: a randomized, controlled trial. Ann Behav Med. 2008;36:21–32.PubMedCrossRef
52.
Mullally WJ, Hall K, Goldstein R. Efficacy of biofeedback in the treatment of migraine and tension type headaches. Pain Physician. 2009;12:1005–11.PubMed
53.
Eccleston C, Palermo TM, Williams AC, Lewandowski A, Morley S. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev. 2009;2:CD003968.PubMed
54.
Hermann C, Kim M, Blanchard EB. Behavioral and prophylactic pharmacological intervention studies of pediatric migraine: an exploratory meta-analysis. Pain. 1995;20:239–56.CrossRef
55.
Holden EW, Deichmann MM, Levy JD. Empirically supported treatments in pediatric psychology: recurrent pediatric headache. J Pediatr Psychol. 1999;24:91–109.PubMedCrossRef
56.
Hermann C, Blanchard EB. Biofeedback in the treatment of headache and other childhood pain. Appl Psychophysiol Biofeedback. 2002;27:143–62.PubMedCrossRef
57.
Nicholson RA, Buse DC, Andrasik F, Lipton RB. Nonpharmacologic treatments for migraine and tension-type headache: how to choose and when to use. Curr Treat Options Neurol. 2011;13:28–40.PubMedCrossRef
58.
Martin PR. Managing headache triggers: think ‘coping’ not ‘avoidance’. Cephalalgia. 2010;30:634–7.PubMed
59.
Martin PR. How do trigger factors acquire the capacity to precipitate headaches? Behav Res Ther. 2001;39:545–54.PubMedCrossRef
60.
Martin PR, Reece J, Forsyth M. Noise as a trigger for headaches: relationship between exposure and sensitivity. Headache. 2006;46:962–72.PubMedCrossRef
61.
Martin PR, Lae L, Reece J. Stress as a trigger for headaches: relationship between exposure and sensitivity. Anxiety Stress Coping. 2007;20:393–407.PubMedCrossRef
62.
Attanasio V, Andrasik F, Blanchard EB. Cognitive therapy and relaxation training in muscle contraction headache: efficacy and cost-effectiveness. Headache. 1987;27:254–60.PubMedCrossRef
63.
Friedman R, Sedler M, Myers P, Benson H. Behavioral medicine, complementary medicine and integrated care. Economic implications. Prim Care. 1997;24:949–62.PubMedCrossRef
64.
Campbell JK, Penzien DB, Wall EM. Evidence-based guidelines for migraine headache: behavioral and physical treatments. US Headache Consortium. 2000. Available at: http://​www.​aan.​com. Accessed July 17, 2012.
65.
Stanos S. Focused review of interdisciplinary pain rehabilitation programs for chronic pain management. Curr Pain Headache Rep. 2012;16:147–52.PubMedCrossRef
66.
Diener HC, Holle D, Dodick D. Treatment of chronic migraine. Curr Pain Headache Rep. 2011;15:64–9.PubMedCrossRef
67.
Flor H, Diers M. Limitations of pharmacotherapy: behavioral approaches to chronic pain. Handb Exp Pharmacol. 2007;177:415–27.
68.
Rossi P, Di Lorenzo C, Faroni J, Cesarino F, Nappi G. Advice alone vs structured detoxification programs for medication overuse headache: a prospective, randomized, open-label trial in transformed migraine patients with low medical needs. Cephalalgia. 2006;26:1097–105.PubMedCrossRef
69.
Fuh JL, Wang SJ. Dependent behavior in patients with medication-overuse headache. Curr Pain Headache Rep. 2012;16:73–9.PubMedCrossRef
70.
Lake 3rd AE. Medication overuse headache: biobehavioral issues and solutions. Headache. 2006;46:s88–97.PubMedCrossRef
71.
Nicholson RA. Chronic headache: the role of the psychologist. Curr Pain Headache Rep. 2010;14:47–54.PubMedCrossRef
72.
Diener HC. Detoxification for medication overuse headache is not necessary. Cephalalgia. 2012;32:423–7.PubMedCrossRef
73.
Grazzi L, Usai S, Prunesti A, Bussone G, Andrasik F. Behavioral plus pharmacological treatment vs pharmacological treatment only for chronic migraine with medication overuse after day-hospital withdrawal. Neurol Sci. 2009;30:S117–9.PubMedCrossRef
Metadata
Title
Behavioral Therapy for Chronic Migraine
Authors
Francesca Pistoia
Simona Sacco
Antonio Carolei
Publication date
01-01-2013
Publisher
Current Science Inc.
Published in
Current Pain and Headache Reports / Issue 1/2013
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-012-0304-9

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