Migraine affects over 12% of the general population and causes major personal and social disability. Mindfulness based stress reduction (MBSR), a standardized type of meditation, has great potential as a treatment for migraine. Migraineurs often do not get relief from standard medications, and many seek out alternative treatments. MBSR has been used to treat various medical ailments including chronic pain disorders, and has proven to be effective in a substantial proportion of patients. The relationship between meditation and brain function and structure has been studied in healthy individuals, but to date there have been no studies examining its effects as a treatment for migraine or other chronic pain conditions. In this project, we aim to assess the efficacy of MBSR for migraine and to determine how brain function and structure change after MBSR treatment. We further aim to assess the relationship between clinical outcomes and brain changes, and determine the effects of MBSR dose through repeated exposure to an MBSR course and long-term practice. Finally, we will examine whether baseline brain measures or early brain changes can predict long-term outcomes related to MBSR treatment. The study will include 90 migraine patients in a randomized control trial comparing MBSR to an educational control group. Patients assigned to the MBSR group will later be randomly assigned to either a second, modified MBSR course, or to usual practice. We will compare clinical outcomes at 3 months (1 month after MBSR or educational control course completion), 6 months (1 month after the second MBSR course completion) and 12 months after study entry. We will perform MRI scans on all patients at baseline and 3 months. Additionally, at 12 months we scan 20 MBSR responders (at least 50% reduction in monthly headache frequency), 20 MBSR non-responders (less than a 25% reduction) and 20 of the educational control group patients who had the greatest reduction in headache frequency. We will also scan a group of 30 healthy age- and sex-matched control subjects at one time point in order to identify aberrant brain structure and function in migraine and observe how these abnormalities resolve with treatment.
Migraine is a debilitating condition in which patients often get insufficient relief from medications and seek alternative treatments. Our study examines the effects of mindfulness based stress reduction (MBSR) as a treatment for migraine and its related effects on brain structure and function. The findings would have direct clinical relevance by showing MBSR is an effective treatment for migraine and other chronic pain conditions and the results on brain mechanisms could lead to improved or new therapies.
