Biofeedback-assisted relaxation in migraine headache: relationship to cerebral blood flow velocity in the middle cerebral artery

Headache. 2003 Mar;43(3):245-50. doi: 10.1046/j.1526-4610.2003.03048.x.


Objective: To determine if migraineurs with aura respond differently to biofeedback/relaxation than those without aura and, if so, whether the variability in outcome can be explained by blood flow velocity. Background.-The relationship between cerebral blood flow velocity and treatment response to biofeedback/relaxation in migraine with and without aura is uncertain.

Method: Twenty migraineurs underwent 12 sessions of biofeedback/relaxation therapy, while 20 controls simply were told to relax on their own. Cerebral blood flow velocity was measured bilaterally in the middle cerebral artery with transcranial Doppler.

Results: The biofeedback group showed significant (P <.05) reductions in pain, depression, and anxiety compared to the control group. Patients with and without aura did equally well. There were significant (P <.05) left to right blood flow velocity differences only in the migraine with aura group. Maximum blood flow velocities were significantly higher (P <.05) in the migraine with aura group than in the cohort without aura. There was an inverse correlation between indicators of anxiety and blood flow velocity, perhaps related to hyperventilation-induced constriction in the small vessels distal to the middle cerebral artery.

Conclusion: The positive treatment response to biofeedback/relaxation in migraine headache is not related to presence of aura, nor to changes in blood flow velocity, but may be associated with reduction in anxiety and depression.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anxiety
  • Biofeedback, Psychology* / methods
  • Blood Flow Velocity
  • Cerebrovascular Circulation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Middle Cerebral Artery / physiopathology*
  • Migraine Disorders / physiopathology*
  • Migraine Disorders / psychology
  • Migraine Disorders / therapy*
  • Migraine with Aura / physiopathology
  • Relaxation Therapy
  • Relaxation*