Departments of Neurology.
Population Health, NYU Langone Health, New York, New York.
Pain Med. 2021 Oct 8;22(10):2366-2383. doi: 10.1093/pm/pnab131.
Neuroscience education therapy (NET) has been successfully used for numerous overlapping pain conditions, but few studies have investigated NET for migraine.
We sought to 1) review the literature on NET used for the treatment of various pain conditions to assess how NET has been studied thus far and 2) recommend considerations for future research of NET for the treatment of migraine.
DESIGN/METHODS: Following the PRISMA guideline for scoping reviews, co-author (TR), a medical librarian, searched the MEDLINE, PsychInfo, Embase, and Cochrane Central Clinical Trials Registry databases for peer-reviewed articles describing NET to treat migraine and other chronic pain conditions. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus.
Overall, a NET curriculum consists of the following topics: pain does not equate to injury, pain is generated in the brain, perception, genetics, reward systems, fear, brain plasticity, and placebo/nocebo effects. Delivered through individual, group, or a combination of individual and group sessions, NET treatments often incorporate exercise programs and/or components of other evidence-based behavioral treatments. NET has significantly reduced catastrophizing, kinesiophobia, pain intensity, and disability in overlapping pain conditions. In migraine-specific studies, when implemented together with traditional pharmacological treatments, NET has emerged as a promising therapy by reducing migraine days, pain intensity and duration, and acute medication intake.
NET is an established treatment for pain conditions, and future research should focus on refining NET for migraine, examining delivery modality, dosage, components of other behavioral therapies to integrate, and migraine-specific NET curricula.
神经科学教育疗法（NET）已成功用于多种重叠的疼痛病症，但很少有研究调查 NET 治疗偏头痛。
我们旨在 1）回顾用于治疗各种疼痛病症的 NET 文献，以评估迄今为止 NET 的研究情况，2）为未来 NET 治疗偏头痛的研究推荐考虑因素。
设计/方法：根据 PRISMA 范围综述指南，合著者（TR），一名医学图书馆员，在 MEDLINE、PsychInfo、Embase 和 Cochrane 中央临床试验注册数据库中搜索了描述 NET 治疗偏头痛和其他慢性疼痛病症的同行评议文章。两名经过培训的独立评审员对每条引文进行了审查。通过共识解决冲突。
总体而言，NET 课程包括以下主题：疼痛不等于损伤、疼痛在大脑中产生、感知、遗传学、奖励系统、恐惧、大脑可塑性和安慰剂/反安慰剂效应。通过个体、小组或个体和小组联合治疗，NET 治疗通常包括运动方案和/或其他基于证据的行为治疗的组成部分。NET 显著降低了重叠疼痛病症中的灾难化、运动恐惧症、疼痛强度和残疾。在偏头痛特异性研究中，当与传统的药物治疗一起实施时，NET 已成为一种有前途的治疗方法，通过减少偏头痛天数、疼痛强度和持续时间以及急性药物摄入来实现。
NET 是一种成熟的疼痛病症治疗方法，未来的研究应侧重于完善偏头痛的 NET，研究传递方式、剂量、其他行为治疗的组成部分以及偏头痛特异性的 NET 课程。
