Differential efficacy of biofeedback in headache.

Abstract

SYNOPSISThis paper presents a retrospective study of 84 headache patients seen in the Behavioural Medicine Unit of Sunnybrook Medical Centre, of whom 53 were treated with biofeedback.Of the 84 patients assessed, half were tension headache and half were migraine. Both groups were treated in one of three ways:1. Frontal EMG FB only.2. Hand skin temperature (HST) only.3. EMG FB followed by HST FB.Assessment results showed the migraine group to have longer headache histories and more severe headaches than the tension group. The tension group had significantly higher frontal muscle tension than the migraine group, while the migraine group had significantly colder peripheral hand temperature. No differences were found in psychometric assessment data.EMG feedback results showed significant decreases in frontal EMG for both headache groups. Both groups showed a moderate improvement in headache at the end of treatment.HST feedback treatment results showed significant increases in peripheral temperature and a significant improvement in headache for those migraine patients who achieved a pre‐determined criterion level of performance. Non‐significant increases in skin temperature occurred for the tension headache group. HST feedback after EMG feedback did not provide further improvement for the tension group. The results are discussed in the context of the differential effects of treatment and highlight the importance of a “trials to criterion” training paradigm.