Psychophysiologic response patterns in migraine before and after temperature biofeedback. Prediction of treatment outcome.

Psychophysiologic response patterns were studied in female migraine patients during headache-free periods (n = 16) and in controls (n = 8). Cardiovascular variables studied were heart rate (HR) and temporal artery pulse wave amplitudes (PWA). Phasic responses to 80-dB, 1000-Hz tones, each lasting 2 sec and sounded at irregular intervals, were studied within a habituation laboratory design. In addition, electromyographic (EMG) levels from the frontal muscles and hand temperature were measured. HR responses were less pronounced and PWA reduction more pronounced in migraine patients than in controls. There were no differences between migraine patients and controls in habituation pattern. Migraine patients showed lower hand temperature and higher EMG levels than controls. Migraine patients were treated with eight temperature biofeedback sessions and were evaluated clinically and psychophysiologically during and 2 months after treatment. Clinical follow-up evaluation was done 2 years after treatment. An average reduction in headache frequency of 66% was reported. A relationship between HR and PWA response pattern before treatment and treatment outcome was found. Migraine patient reporting most pronounced clinical improvement showed a "normalization" of the PWA response pattern after treatment.