Cited by 110Migraine and Headache StudiesMindfulness and Compassion InterventionsTemporomandibular Joint Disorders

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Enhanced mindfulness-based stress reduction in episodic migraine: a randomized clinical trial with magnetic resonance imaging outcomes

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Seminowicz, David A., Burrowes, Shana A.B., Kearson, Alexandra, Zhang, Jing, Krimmel, Samuel R., Samawi, Luma, Furman, Andrew J., Keaser, Michael L., Gould, Neda F., Magyari, Trish, White, Linda, Goloubeva, Olga, Goyal, Madhav, Peterlin, B. Lee, Haythornthwaite, Jennifer A.·2020·Pain

DOI 10.1097/j.pain.0000000000001860PMC PMC7487005

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Abstract

We aimed to evaluate the efficacy of an enhanced mindfulness-based stress reduction (MBSR+) vs 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) with SMH (n = 48). MBSR+ and SMH were delivered weekly by group for 8 weeks, then biweekly for another 8 weeks. The primary clinical outcome was reduction in headache days from baseline to 20 weeks. Magnetic resonance imaging (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 to DLPFC and cognitive task network, and gray matter volume of DLPFC, dorsal anterior insula, 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). Fifty-two percent 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. Enhanced mindfulness-based stress reduction is an effective treatment option for episodic migraine.

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Additional file 1 of Differences in gray matter volume in episodic migraine patients with and without prior diagnosis or clinical care: a cross-sectional study
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Authors: Seminowicz, D. A., Burrowes, S. A. B., Kearson, A., Zhang, J., Krimmel, S. R., Samawi, L., Furman, A. J., Keaser, M. L., Gould, N. F., Magyari, T., White, L., Goloubeva, O., Goyal, M., Peterlin, B. L., & Haythornthwaite, J. A.
Affiliations: University of Maryland, Baltimore (US)
Johns Hopkins University (US)
Private Mindfulness-based Psychotherapy Practice, Baltimore, MD, United States
Lancaster General Hospital (US)
Corresponding author: Seminowicz, David A.
ORCID: Seminowicz, David A.
Burrowes, Shana A.B.
Zhang, Jing
Krimmel, Samuel R.
Furman, Andrew J.
Gould, Neda F.
Goyal, Madhav
Peterlin, B. Lee
Haythornthwaite, Jennifer A.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2020-03-13
Volume: 161
Issue: 8
Pages: 1837-1846
ISSN: 0304-3959 (ISSN-L)
1872-6623
DOI: 10.1097/j.pain.0000000000001860
PMC: PMC7487005
OpenAlex: W3011034657
Semantic Scholar: 3d5ba40ad69901727f6798ee12e8fd95d3480d26
Cited by: 110
References: 81
Citations by year: 2026: 5 · 2025: 18 · 2024: 18 · 2023: 21 · 2022: 22 · 2021: 17 · 2020: 7
FWCI: 12.15
Type: journal article
Language: en
Open access: green
doi.org
Licence: cc-by-nc-nd
Locations: Pain (publishedVersion)
medRxiv (acceptedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (NIH-R01)
National Center for Complementary and Integrative Health (AT007176, R01AT007176)
Topics: Health Sciences › Medicine › Clinical Neurology › Migraine and Headache Studies
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
Keywords: episodic migraine, mindfulness-based stress reduction, headache days, headache-related disability, dorsolateral prefrontal cortex, dorsal anterior insula, anterior midcingulate cortex, resting-state functional connectivity, gray matter volume
MeSH terms: Adolescent, Adult, Aged, Female, Headache, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Migraine Disorders, Stress, Psychological, Treatment Outcome, Young Adult, Neuroimaging, Mindfulness

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Enhanced mindfulness-based stress reduction in episodic migraine: a randomized clinical trial with magnetic resonance imaging outcomes

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