Cognitive therapy, relaxation training both beneficial for migraine

For adults with migraine, migraine-specific, integrative cognitive behavioral therapy (miCBT) and relaxation training (RLX) are both beneficial, with no significant between-group difference seen at follow-up, according to a study published online April 28 in Frontiers in Neurology.

Timo Klan, Ph.D., from the Johannes Gutenberg University of Mainz in Germany, and colleagues conducted a three-armed, open-label trial involving 121 adults with migraine who were assigned to miCBT combining several approaches (trigger and stress management, coping with fear of attacks, relaxation training), a single behavioral approach (RLX) as an active control group, and a waiting-list control group (WLC). miCBT and RLX consisted of seven 90 minute sessions. Participants who completed WLC were then randomly assigned to the treatment groups.

The researchers found that significantly stronger pre-post improvement in self-efficacy was seen in both treatment groups compared with WLC in mixed-model analyses of the intention-to-treat sample; there were no other significant between-group differences. In follow-up analyses, significant within-group improvements were seen from baseline to 12-month follow-up for both treatments in all four primary outcomes (headache days, headache-related disability, emotional distress, and self-efficacy). At follow-up, between-group effects (miCBT versus RLX) were not significant.

"In the follow-up, both interventions yielded significant within-group improvements in most of the outcomes," the authors write. "However, and contrary to expectations, miCBT was not superior to RLX in improving clinical outcomes, neither in the pre-post analyses nor in the follow-up analyses."