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Meta-Analysis
. 2021 Dec 28;58(1):44.
doi: 10.3390/medicina58010044.

Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and Meta-Analysis

Ji-Yong Bae  1 , Hyun-Kyung Sung  2 , Na-Yoen Kwon  3 , Ho-Yeon Go  4 , Tae-Jeong Kim  2 , Seon-Mi Shin  5 , Sangkwan Lee  6   7
Affiliations
Meta-Analysis

Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and Meta-Analysis

Ji-Yong Bae et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Migraine headaches are chronic neurological diseases that reduce the quality of life by causing severe headaches and autonomic nervous system dysfunction, such as facial flushing, nasal stuffiness, and sweating. Their major treatment methods include medication and cognitive behavioral therapy (CBT). CBT has been used for pain treatment and various psychogenic neurological diseases by reducing pain, disability, and emotional disorders caused by symptoms of mental illness and improving the understanding of mental health. This study aimed to evaluate the effectiveness and safety of CBT in treating migraines. Materials and Methods: Seven electronic databases were searched from the date of inception to December 2020. Randomized controlled studies (RCTs) using CBT as an intervention for migraine were included. The primary outcome of this study was to determine the frequency of migraines and the intensity of migraines on Visual Analog Scale (VAS), the frequency of drug use, Migraine Disability Assessment (MIDAS), and Headache Impact Test (HIT-6) index. The two authors independently conducted the data extraction and quality assessment of the included RCTs, and conducted meta-analysis with RevMan V.5.4. Results: Among the 373 studies, 11 RCTs were included in this systematic review. Seven out of the 11 RCTs were conducted in the USA, and four were conducted in the UK, Germany, Iran, and Italy, respectively. Headache frequency and MIDAS scores were statistically significant reduced. In the subgroup analysis, headache strength was significantly reduced. Two of the included studies reported adverse effects, including worsening of migraine intensity and frequency, respiratory symptoms, and vivid memory of a traumatic event. Conclusions: CBT for migraine effectively reduced headache frequency and MIDAS score in meta-analysis and headache intensity subgroup analysis, with few adverse events. Additional RCTs with CBT for migraine headaches are needed for a more accurate analysis.

Keywords: cognitive behavioral therapy; headache; migraine; migraine headache; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scheme of the data selection process.
Figure 2
Figure 2
Assessment of risk of bias. (A): Risk of bias graph. (B): Risk of bias summary.
Figure 2
Figure 2
Assessment of risk of bias. (A): Risk of bias graph. (B): Risk of bias summary.
Figure 3
Figure 3
Subgroup analysis of cognitive behavioral treatment compared with the education group regarding the difference from baseline in headache frequency.
Figure 4
Figure 4
Subgroup analysis of cognitive behavioral treatment compared with the WL/TAU/SMC group regarding the difference from baseline in headache frequency.
Figure 5
Figure 5
Subgroup analysis of cognitive behavioral treatment compared with the education group regarding the difference from baseline in Pediatric Migraine Disability Assessment score.
Figure 6
Figure 6
Subgroup analysis of cognitive behavioral treatment compared with the WL/TAU/SMC group regarding the difference from baseline in Pediatric Migraine Disability Assessment score.
Figure 7
Figure 7
Subgroup analysis of cognitive behavioral treatment compared with the WL/TAU/SMC group for difference from baseline in Headache Impact Test (HIT-6) score.
See this image and copyright information in PMC

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