Randomized controlled trial of neurofeedback mindfulness meditation as a practice for migraine management.

A randomized controlled trial compared eight weeks of daily neurofeedback mindfulness meditation (NM) to an audiobook listening task in 101 adults with migraine. Both groups showed improvements in headache disability, severity, and anxiety, but between-group differences were small and inconclusive. Only headache management self-efficacy improved significantly more in the NM group than in the control group. Within the NM group, greater self-efficacy correlated with lower migraine disability, severity, and anxiety. Biological sex, belief in meditation, and migraine subtypes did not influence outcomes. The authors argue that NM may enhance self-agency, potentially aiding migraine recovery and prevention, but larger trials are needed.

Study at a glance

Abstract

Recent studies indicate that mindfulness meditation may be beneficial for migraine symptoms; yet the potential of neurofeedback mindfulness meditation (NM) remains unexplored. This randomized controlled trial investigates the efficacy of NM compared to a controlled attention task for managing migraine. 101 adults with migraine participated in the study, wearing EEG headbands and engaging in 10-minute daily sessions of either NM (n = 49) or an audiobook listening task (n = 52) for eight weeks. While EEG raw data was collected for all participants, only the NM group had real-time access to their EEG neurofeedback. We assessed migraine characteristics (disability and severity), headache management self-efficacy, and psychiatric symptoms (anxiety and depression) before and after the intervention. Data from 61 participants who completed the full 8-week intervention were analyzed. Improvements in headache disability, severity, and anxiety were observed in both NM (n = 34) and control (n = 27) groups; however, between-group comparisons were inconclusive and minimal (DiD 95 % CIs crossing zero). Only headache management self-efficacy showed a statistically significant between-group improvement showing greater improvement in headache management self-efficacy compared to the control group (F(1,59) = 4.56, p < 0.05, ηp2 = 0.07; DiD = 10.3; 95 % CI 0.65-19.87). Additionally, increased headache management self-efficacy was negatively correlated with migraine disability (r = -0.39, p < 0.05), severity (r = -0.41, p < 0.05), and anxiety (r = -0.47, p < 0.05) within the NM group. Biological sex, belief in meditation, and migraine subtypes did not significantly influence the study outcomes, suggesting that these variables did not act as confounding factors in the observed effects (p > 0.05). The findings indicate that neurofeedback mindfulness meditation enhances headache management self-efficacy, yet larger trials are required to estimate effects with adequate precision. We discuss how improved self-agency may foster greater awareness and behavioural control over internal and external adjustments, ultimately leading to effective migraine recovery and prevention.