MRI outcomes of mindfulness meditation for migraine

描述（由申请人提供）：偏头痛影响超过12%的普通人群，并导致主要的个人和社会残疾。正念减压（MBSR）是一种标准化的冥想，在治疗偏头痛方面有很大的潜力。偏头痛患者通常不能从标准药物中得到缓解，许多人寻求替代治疗。正念减压疗法已被用于治疗各种疾病，包括慢性疼痛障碍，并已被证明对相当比例的患者有效。冥想与大脑功能和结构之间的关系已经在健康个体中进行了研究，但到目前为止，还没有研究调查冥想治疗偏头痛或其他慢性疼痛状况的效果。在这个项目中，我们旨在评估正念减压疗法对偏头痛的疗效，并确定正念减压疗法治疗后大脑功能和结构的变化。我们进一步旨在评估临床结果与大脑变化之间的关系，并通过反复暴露于正念减压课程和长期实践来确定正念减压剂量的影响。最后，我们将研究基线大脑测量或早期大脑变化是否可以预测与正念减压治疗相关的长期结果。这项研究将包括90名偏头痛患者进行随机对照试验，将正念减压疗法与教育对照组进行比较。被分配到正念减压疗法组的患者随后将被随机分配到第二个修改后的正念减压疗法组或常规疗法组。我们将比较研究开始后3个月（MBSR或教育控制课程完成后1个月）、6个月（第二次MBSR课程完成后1个月）和12个月的临床结果。我们将在基线和3个月时对所有患者进行MRI扫描。此外，在12个月时，我们扫描了20名有MBSR反应的患者（每月头痛频率减少至少50%），20名无MBSR反应的患者（减少少于25%）和20名头痛频率减少最多的教育对照组患者。我们还将在同一时间点扫描一组30名年龄和性别匹配的健康对照受试者，以确定偏头痛患者的异常大脑结构和功能，并观察这些异常如何随着治疗而消退。

DESCRIPTION (provided by applicant): Migraine affects over 12% of the general population and causes major personal and social disability. Mindfulness based stress reduction (MBSR), a standardized type of meditation, has great potential as a treatment for migraine. Migraineurs often do not get relief from standard medications, and many seek out alternative treatments. MBSR has been used to treat various medical ailments including chronic pain disorders, and has proven to be effective in a substantial proportion of patients. The relationship between meditation and brain function and structure has been studied in healthy individuals, but to date there have been no studies examining its effects as a treatment for migraine or other chronic pain conditions. In this project, we aim to assess the efficacy of MBSR for migraine and to determine how brain function and structure change after MBSR treatment. We further aim to assess the relationship between clinical outcomes and brain changes, and determine the effects of MBSR dose through repeated exposure to an MBSR course and long-term practice. Finally, we will examine whether baseline brain measures or early brain changes can predict long-term outcomes related to MBSR treatment. The study will include 90 migraine patients in a randomized control trial comparing MBSR to an educational control group. Patients assigned to the MBSR group will later be randomly assigned to either a second, modified MBSR course, or to usual practice. We will compare clinical outcomes at 3 months (1 month after MBSR or educational control course completion), 6 months (1 month after the second MBSR course completion) and 12 months after study entry. We will perform MRI scans on all patients at baseline and 3 months. Additionally, at 12 months we scan 20 MBSR responders (at least 50% reduction in monthly headache frequency), 20 MBSR non-responders (less than a 25% reduction) and 20 of the educational control group patients who had the greatest reduction in headache frequency. We will also scan a group of 30 healthy age- and sex-matched control subjects at one time point in order to identify aberrant brain structure and function in migraine and observe how these abnormalities resolve with treatment.