Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy.
UOC Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy.
Int J Environ Res Public Health. 2022 Oct 29;19(21):14116. doi: 10.3390/ijerph192114116.
This preliminary analysis of a single-blind phase-III RCT aims to compare the feasibility and short-term efficacy of mindfulness as an add-on to treatment as usual (TaU) in the management of patients with chronic migraine (CM) and medication overuse headache (MOH). Patients were randomized to either TaU (structured withdrawal of overused drugs, patient education and pharmacological prophylaxis) or TaU + MIND, wherein patients additionally received six 90 min weekly group sessions of mindfulness-based therapy. Repeated measures analyses were used to test whether patients in the two arms showed different course with regard to headache frequency and medication intake over a three-month period. Drop-out rates were not different between the two groups: 6/89 (6.7%) and 9/88 (10.2%) among those in TaU and TaU + MIND, respectively. A significant effect of time for all variables was shown, together with a significant effect of time by group, favoring TaU + MIND condition for headache frequency ( = 0.025) and NSAID intake ( = 0.007), controlling for age and CM duration. In total, 45/83 (54.2%) and 69/79 (75.9%) of the patients allocated to TaU and TaU + MIND, respectively, achieved 50% or more headache-day reduction (chi-squared 8.38, = 0.004). Our preliminary analysis indicates that adding six mindfulness-based sessions to TaU was feasible and showed short-term efficacy in the treatment of patients with CM and MOH.
本单盲 III 期 RCT 的初步分析旨在比较正念作为慢性偏头痛 (CM) 和药物过度使用性头痛 (MOH) 患者治疗中附加治疗 (TaU) 的辅助手段的可行性和短期疗效。患者被随机分为 TaU(过度使用药物的结构化停药、患者教育和药物预防)或 TaU+MIND,其中患者另外接受六次每周 90 分钟的正念为基础的团体治疗。重复测量分析用于测试在三个月的时间内,两组患者在头痛频率和药物摄入方面是否表现出不同的病程。两组的脱落率无差异:TaU 组为 6/89(6.7%),TaU+MIND 组为 9/88(10.2%)。所有变量的时间均显示出显著的影响,同时时间与组的显著交互作用也显示出有利于 TaU+MIND 条件的头痛频率(=0.025)和 NSAID 摄入(=0.007),控制年龄和 CM 持续时间。总共,分别有 45/83(54.2%)和 69/79(75.9%)的患者被分配到 TaU 和 TaU+MIND,分别达到 50%或更多的头痛日减少(卡方 8.38,=0.004)。我们的初步分析表明,在 TaU 中增加六次正念课程是可行的,并且在治疗 CM 和 MOH 患者方面显示出短期疗效。