Enhanced mindfulness based stress reduction (MBSR+) in episodic migraine: a randomized clinical trial with MRI outcomes
David A Seminowicz, Shana A B Burrowes, A. Kearson, Jing Zhang, Samuel R Krimmel, L. Samawi, Andrew J. Furman, Michael L. Keaser, Neda F Gould, T. Magyari, Linda White, Olga Goloubeva, Madhav Goyal, B. Peterlin, Jennifer A. Haythornthwaite
Pain March 13, 2020 DOI: 10.1097/j.pain.0000000000001860 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized, assessor-blind, clinical trial Peer reviewed |
|---|---|
| Sample size | 98 |
| Population | Adults with episodic migraine recruited at a single academic center |
| Interventions | Enhanced mindfulness-based stress reduction (MBSR+) Stress management for headache (SMH) |
| Duration | 8-week weekly sessions then 8-week bi-weekly sessions; primary outcome at 20 weeks; follow-up at 52 weeks |
| Topics | Meditation |
| Key findings | MBSR+ reduced headache days more than SMH at 20 weeks, with a greater response rate and disability improvement, but no differences at 52 weeks or in MRI outcomes. |
Abstract
We aimed to evaluate the efficacy of an enhanced mindfulness based stress reduction (MBSR+) versus stress management for headache (SMH). We performed a randomized, assessor-blind, clinical trial of 98 adults with episodic migraine recruited at a single academic center comparing MBSR+ (n=50) to SMH (n=48). MBSR+ and SMH were delivered weekly by group for 8 weeks, then bi-weekly for another 8 weeks. The primary clinical outcome was reduction in headache days from baseline to 20 weeks. MRI outcomes included activity of left dorsolateral prefrontal cortex (DLPFC) and cognitive task network during cognitive challenge, resting state connectivity of right dorsal anterior insula (daINS) to DLPFC and cognitive task network, and gray matter volume of DLPFC, daINS, and anterior midcingulate. Secondary outcomes were headache-related disability, pain severity, response to treatment, migraine days, and MRI whole-brain analyses. Reduction in headache days from baseline to 20 weeks was greater for MBSR+ (7.8 [95%CI, 6.9–8.8] to 4.6 [95%CI, 3.7–5.6]) than for SMH (7.7 [95%CI 6.7–8.7] to 6.0 [95%CI, 4.9–7.0]) (P=0.04). 52% of the MBSR+ group showed a response to treatment (50% reduction in headache days) compared with 23% in the SMH group (P=0.004). Reduction in headache-related disability was greater for MBSR+ (59.6 [95%CI, 57.9–61.3] to 54.6 [95%CI, 52.9–56.4]) than SMH (59.6 [95%CI, 57.7–61.5] to 57.5 [95%CI, 55.5–59.4]) (P=0.02). There were no differences in clinical outcomes at 52 weeks or MRI outcomes at 20 weeks, although changes related to cognitive networks with MBSR+ were observed. MBSR+ is an effective treatment option for episodic migraine.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 34
- Disentangling self from pain: mindfulness meditation–induced pain relief is driven by thalamic–default mode network decoupling Pain July 7, 2022
- Mechanism of Action of Mindfulness-Based Interventions for Pain Relief-A Systematic Review. Journal of Integrative and Complementary Medicine December 1, 2024
- Longitudinal neurofunctional changes in medication overuse headache patients after mindfulness practice in a randomized controlled trial (the MIND-CM study). The Journal of Headache and Pain June 11, 2024
- Is Mindfulness Associated With Lower Pain Reactivity and Connectivity of the Default Mode Network? A Replication and Extension Study in Healthy and Episodic Migraine Participants Journal of Pain August 4, 2022
- The Mindful Reappraisal of Pain Scale (MRPS): Validation of a New Measure of Psychological Mechanisms of Mindfulness-Based Analgesia. Mindfulness 2023
and 29 more in the library
Cites 18
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- Cognitive-Affective Neural Plasticity following Active-Controlled Mindfulness Intervention Journal of Neuroscience October 31, 2012
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis Cephalalgia June 4, 2018
and 13 more in the library