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Biofeedback-Virtual Reality Tool Shows Promise for Patients With Chronic Migraine

Biofeedback-Virtual Reality Tool Shows Promise for Patients With Chronic Migraine

The following article is part of conference coverage from the 2022 American Academy of Neurology (AAN) Annual Meeting. Neurosurgeon Staff will report on breaking news related to research conducted by leading experts in neuroscience. Check back for the latest news from the 2022 AAN Annual Meeting.

Regular use of add-on biofeedback and virtual reality therapy in patients with chronic migraine significantly reduced acute medication use, according to a 12-week randomized, controlled pilot study presented at the 2022 American Academy of Neurology (AAN) annual meeting, held From April 2 to April 7 in Seattle, Washington, and approximately from April 24 to 26, 2022.

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Recognizing that chronic migraine is a common and disabling disorder, researchers sought to determine whether frequent use of a device combining biofeedback and virtual reality was associated with improvements in chronic migraine, including number of headache days, frequency of acute medication use, and associated migraine headaches. Disability and Depression (Patient Health Questionnaire-8 [PHQ-8]) and anxiety (a scale of perceived stress [PSS]), sleep disturbance (patient-reported outcome measurement information system [PROMIS]), and exaggeration (fears about pain [CAP]) – all measured at weeks 0, 2, 4, 8 and 12.

They hypothesized that using biofeedback along with virtual reality might be an effective treatment for patients with chronic migraines—particularly those who are deprived of drug therapy. Patients were identified as medically refractory, according to the American Headache Association or European Headache Federation criteria.

Biofeedback is a mind-body breathing technique that modulates the autonomic nervous system. Behavioral therapies such as biofeedback have been shown to reduce headache-related outcomes in patients with episodic migraines by 35% to 55%.

A total of 50 patients aged 18–85 years with a diagnosis of ICHD-3 chronic migraine were recruited from the Headache Clinic at the University of Washington in Seattle. Participants were randomly assigned to the intervention group (ie, frequent use of biofeedback-virtual reality in addition to standard medical care) or to a waiting list control group (ie, standard medical care alone), with 25 patients enrolled in each study group.

A statistically significant decrease in the frequency of acute medication use was reported in the intervention group versus the control group members (55% vs 32%, respectively; s = .028). Although improvements were also observed in the other variables, these values ​​were not statistically significant. The majority of patients (ie 69%) met the medical criteria for treatment-resistant migraine.

The researchers concluded that “Biofeedback-virtual reality is a safe, non-invasive treatment that shows promise for many patients, including those with medically refractory CM, interested in non-pharmacological approaches, and/or those inclined to an integrative treatment strategy.”

Disclosure: None of the study authors disclosed their affiliations with biotechnology, pharmaceutical, and/or device companies.


Kunio A, Yang R, Wang K, et al. Benefit of a new and combined biofeedback and virtual reality tool as an add-on therapy for chronic migraine. Presented at: 2022 AAN Annual Meeting; 2-7 April 2022; Seattle, Washington; 24-26 April 2022; Virtual meeting. Abstract S31.009.

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