Abstract
Aim: To address whether, in patients with chronic migraine and medication overuse headache, mindfulness-based treatment is associated with changes in plasma levels of catecholamines and elusive amines that are similar to those observed in patients undergoing pharmacological prophylaxis. Methods: In this non-randomized, clinic-based effectiveness study, patients aged 18–65, with a history of chronic migraine ≥ 10 years and overuse of triptans or non-steroidal anti-inflammatory drugs ≥ 5 years, were enrolled. Upon completion of a structured withdrawal program, patients received either pharmacological prophylaxis or six weekly sessions of mindfulness-based treatment and were followed for 12 months. Daily headache diaries were used to record headache frequency and medication intake; catecholamines (noradrenaline, epinephrine and dopamine) and levels of elusive amines were assayed from poor platelet plasma. Results: Complete follow-up data were available for 15 patients in the pharmacological prophylaxis-group (14 females, average age 44.1) and 14 in the mindfulness treatment-group (all females, average age 46.4), and all variables were comparable between groups at baseline. At 12 months, significant improvement (p <.001) was found in the pharmacological prophylaxis group for headache frequency and medication intake (by 51% and 48.7%, respectively), noradrenaline, epinephrine and dopamine (by 98.7%, 120.8% and 501.9%, respectively); patients in the mindfulness treatment-group performed similarly. For elusive amines, no longitudinal changes were found. Conclusions: The similar improvement trends observed in the two groups of patients further support the utility of mindfulness-based treatment in migraine care, and reinforce the hypothesis that alteration and normalization of tyrosine metabolism are implicated in migraine chronification and in remission of chronic migraine.
| Original language | English |
|---|---|
| Journal | Cephalalgia |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- catecholamines
- Chronic migraine
- generalized estimating equation (GEE) models
- mindfulness
- pharmacological prophylaxis
ASJC Scopus subject areas
- Clinical Neurology
Cite this
A prospective pilot study of the effect on catecholamines of mindfulness training vs pharmacological prophylaxis in patients with chronic migraine and medication overuse headache. / Grazzi, Licia; Raggi, Alberto; D’Amico, Domenico; Sansone, Emanuela; Leonardi, Matilde; Andrasik, Frank; Gucciardi, Antonina; Guido, Davide; D’Andrea, Giovanni.
In: Cephalalgia, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A prospective pilot study of the effect on catecholamines of mindfulness training vs pharmacological prophylaxis in patients with chronic migraine and medication overuse headache
AU - Grazzi, Licia
AU - Raggi, Alberto
AU - D’Amico, Domenico
AU - Sansone, Emanuela
AU - Leonardi, Matilde
AU - Andrasik, Frank
AU - Gucciardi, Antonina
AU - Guido, Davide
AU - D’Andrea, Giovanni
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Aim: To address whether, in patients with chronic migraine and medication overuse headache, mindfulness-based treatment is associated with changes in plasma levels of catecholamines and elusive amines that are similar to those observed in patients undergoing pharmacological prophylaxis. Methods: In this non-randomized, clinic-based effectiveness study, patients aged 18–65, with a history of chronic migraine ≥ 10 years and overuse of triptans or non-steroidal anti-inflammatory drugs ≥ 5 years, were enrolled. Upon completion of a structured withdrawal program, patients received either pharmacological prophylaxis or six weekly sessions of mindfulness-based treatment and were followed for 12 months. Daily headache diaries were used to record headache frequency and medication intake; catecholamines (noradrenaline, epinephrine and dopamine) and levels of elusive amines were assayed from poor platelet plasma. Results: Complete follow-up data were available for 15 patients in the pharmacological prophylaxis-group (14 females, average age 44.1) and 14 in the mindfulness treatment-group (all females, average age 46.4), and all variables were comparable between groups at baseline. At 12 months, significant improvement (p <.001) was found in the pharmacological prophylaxis group for headache frequency and medication intake (by 51% and 48.7%, respectively), noradrenaline, epinephrine and dopamine (by 98.7%, 120.8% and 501.9%, respectively); patients in the mindfulness treatment-group performed similarly. For elusive amines, no longitudinal changes were found. Conclusions: The similar improvement trends observed in the two groups of patients further support the utility of mindfulness-based treatment in migraine care, and reinforce the hypothesis that alteration and normalization of tyrosine metabolism are implicated in migraine chronification and in remission of chronic migraine.
AB - Aim: To address whether, in patients with chronic migraine and medication overuse headache, mindfulness-based treatment is associated with changes in plasma levels of catecholamines and elusive amines that are similar to those observed in patients undergoing pharmacological prophylaxis. Methods: In this non-randomized, clinic-based effectiveness study, patients aged 18–65, with a history of chronic migraine ≥ 10 years and overuse of triptans or non-steroidal anti-inflammatory drugs ≥ 5 years, were enrolled. Upon completion of a structured withdrawal program, patients received either pharmacological prophylaxis or six weekly sessions of mindfulness-based treatment and were followed for 12 months. Daily headache diaries were used to record headache frequency and medication intake; catecholamines (noradrenaline, epinephrine and dopamine) and levels of elusive amines were assayed from poor platelet plasma. Results: Complete follow-up data were available for 15 patients in the pharmacological prophylaxis-group (14 females, average age 44.1) and 14 in the mindfulness treatment-group (all females, average age 46.4), and all variables were comparable between groups at baseline. At 12 months, significant improvement (p <.001) was found in the pharmacological prophylaxis group for headache frequency and medication intake (by 51% and 48.7%, respectively), noradrenaline, epinephrine and dopamine (by 98.7%, 120.8% and 501.9%, respectively); patients in the mindfulness treatment-group performed similarly. For elusive amines, no longitudinal changes were found. Conclusions: The similar improvement trends observed in the two groups of patients further support the utility of mindfulness-based treatment in migraine care, and reinforce the hypothesis that alteration and normalization of tyrosine metabolism are implicated in migraine chronification and in remission of chronic migraine.
KW - catecholamines
KW - Chronic migraine
KW - generalized estimating equation (GEE) models
KW - mindfulness
KW - pharmacological prophylaxis
UR - http://www.scopus.com/inward/record.url?scp=85060342527&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060342527&partnerID=8YFLogxK
U2 - 10.1177/0333102418801584
DO - 10.1177/0333102418801584
M3 - Article
AN - SCOPUS:85060342527
JO - Cephalalgia
JF - Cephalalgia
SN - 0333-1024
ER -