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Review
. 2022 Aug 11;23(1):100.
doi: 10.1186/s10194-022-01471-3.

Applying a biopsychosocial model to migraine: rationale and clinical implications

Chiara Rosignoli  1 , Raffaele Ornello  1 , Agnese Onofri  1 , Valeria Caponnetto  1 , Licia Grazzi  2 , Alberto Raggi  3 , Matilde Leonardi  3 , Simona Sacco  4
Affiliations
Review

Applying a biopsychosocial model to migraine: rationale and clinical implications

Chiara Rosignoli et al. J Headache Pain. .

Erratum in

Abstract

Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.

Keywords: Allostatic load; Biopsychosocial; Central sensitization; Chronic pain; Complementary treatment; Environmental factors; Migraine.

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Conflict of interest statement

R.O. reports personal fees from Novartis, Teva, and Eli Lilly, and had non-financial relationships with Allergan/AbbVie, Novartis and Teva. S.S. reports personal fees or nonfinancial support from Allergan, Abbott, Eli Lilly, Novartis, Teva, Medscape, Bayer, Pfizer, Medtronic, Starmed, Bristol-Myers Squibb, and Daiichi Sankyo. L.G. has received consultancy and advisory fees from Allergan SpA, TEVA Pharm, Eli lilly, Novartis AG. A.O., V.C., C.R., M.L. and A.R. report no competing interest.

Figures

Fig. 1
Fig. 1
Schematic representation of migraine patterns. Those patterns can change and revert throughout patients’ life
Fig. 2
Fig. 2
Biological, social, and psychological factors influencing migraine
Fig. 3
Fig. 3
The vicious cycle of migraine comorbidities and stressors. Created with https://biorender.com/
Fig. 4
Fig. 4
A hierarchical view of the biopsychosocial model as applicable to migraine
See this image and copyright information in PMC

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