MRI outcomes of mindfulness meditation for migraine

描述(申请人提供)：偏头痛影响超过12%的总人口，并导致严重的个人和社会残疾。基于正念的压力减轻(MBSR)是一种标准化的冥想类型，作为偏头痛的治疗方法具有巨大的潜力。偏头痛患者通常不会从标准药物中得到缓解，许多人会寻找替代疗法。MBSR已被用于治疗包括慢性疼痛障碍在内的各种疾病，并已被证明在相当大比例的患者中有效。冥想与大脑功能和结构之间的关系已经在健康的人中进行了研究，但到目前为止，还没有研究表明冥想对偏头痛或其他慢性疼痛的治疗效果。在这个项目中，我们的目标是评估MBSR治疗偏头痛的疗效，并确定MBSR治疗后大脑功能和结构的变化。我们的进一步目标是评估临床结果和脑变化之间的关系，并通过反复暴露于MBSR疗程和长期实践来确定MBSR剂量的影响。最后，我们将检查基线脑测量或早期脑变化是否可以预测与MBSR治疗相关的长期结果。这项研究将包括90名偏头痛患者参加随机对照试验，将MBSR与教育对照组进行比较。分配到MBSR组的患者稍后将被随机分配到第二个改良的MBSR疗程，或按惯例进行。我们将比较3个月(MBSR或教育控制课程结束后1个月)、6个月(第二次MBSR课程完成后1个月)和研究开始后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个月后，我们扫描了20名MBSR应答者(每月头痛频率至少减少了50%)、20名MBSR无应答者(减少不到25%)和20名头痛频率减少最多的教育控制组患者。我们还将在某个时间点对30名年龄和性别匹配的健康对照组受试者进行扫描，以确定偏头痛患者大脑结构和功能的异常，并观察这些异常是如何通过治疗解决的。

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.