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Abstract
Objective Evaluate whether the benefits of Mindfulness-Based Cognitive Therapy for Migraine (MBCT-M) on headache disability differs among people with episodic and chronic migraine (CM).
Methods This is a planned secondary analysis of a randomized clinical trial. After a 30-day baseline, participants were stratified by episodic (6–14 d/mo) and CM (15–30 d/mo) and randomized to 8 weekly individual sessions of MBCT-M or wait list/treatment as usual (WL/TAU). Primary outcomes (Headache Disability Inventory; Severe Migraine Disability Assessment Scale [scores ≥ 21]) were assessed at months 0, 1, 2, and 4. Mixed models for repeated measures tested moderation with fixed effects of treatment, time, CM, and all interactions. Planned subgroup analyses evaluated treatment*time in episodic and CM.
Results Of 60 participants (MBCT-M N = 31, WL/TAU N = 29), 52% had CM. CM moderated the effect of MBCT-M on Severe Migraine Disability Assessment Scale, F(3, 205) = 3.68, p = 0.013; MBCT-M vs WL/TAU reduced the proportion of people reporting severe disability to a greater extent among people with episodic migraine (−40.0% vs −14.3%) than CM (−16.4% vs +8.7%). Subgroup analysis revealed MBCT-M (vs WL/TAU) significantly reduced Headache Disability Inventory for episodic (p = 0.011) but not CM (p = 0.268).
Conclusions MBCT-M is a promising treatment for reducing headache-related disability, with greater benefits in episodic than CM.
Trial Registration Information ClinicalTrials.gov Identifier: NCT02443519.
Classification of Evidence This study provides Class III evidence that MBCT-M reduces headache disability to a greater extent in people with episodic than CM.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
- Received April 2, 2020.
- Accepted September 21, 2020.
- © 2021 American Academy of Neurology
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