Neurofeedback in the Comprehensive Treatment of Migraines / Impact of Neurofeedback on Migraine Pain and Frequency when migraine is co-morbid with other stress related conditions

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     Migraine symptoms have been very responsive to Neurofeedback.  They respond to both eeg neurofeedback and to pirHEG neurofeedback.  This is clear both in my psychiatric practice and generally in the field of Biofeedback.   It has been my experience that when patients in my practice decide to engage in neurofeedback for their stress-related conditions (mood issues, attention issues, anxiety, trauma, etc), their migraine attacks reduce in frequency and intensity, often to the point that they feel their migraines “are gone”. 

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     Biofeedback, of which traditional EEG neurofeedback is a subset, has long been approved by the FDA for use in migraine treatment.   In my initial work with neurofeedback, my second volunteer (me) was suffering from frequent migraines, and at increasing frequency and intensity due to peri-menopausal symptoms.  This was one reason I pursued training in eeg neurofeedback.  I had heard clinicians describing its usefulness in eliminating migraines.  It was my experience that my migraine symptoms --  as well as all my peri-menopausal symptoms (irritability, increased PMS, increased sleep-onset difficulties with insomnia)—were eliminated with eeg neurofeedback.   Of interest, the PMS symptoms resolved so completely that I had to begin writing down my menstrual cycle (day of onset) because I could no longer tell my period was coming.  (The irritability and sleep issues and migraine signals were gone!)

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     My migraines resolved completely, such that I was surprised to notice one day that my migraine abortive medication (Maxalt, a triptan) was completely expired, and none of them had been used.  That was when I realized that neurofeedback has a potent effect on migraine pain, frequency, and aura.  I have never needed a prescription for migraine medication again.  And, also surprising to me, my migraines remained in remission for six years or so, and when I had any hint of an aura or a mild hint of a headache, which occurred at the most once every few years, I would give myself a session or two and the migraines would recede again powerfully and in a sustained way.

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     What I have seen in my patients is that although my patients are not coming to me for migraine treatment, I look forward to seeing not only improvement in their emotional stress related symptoms, but I will likely see significant improvement -- very possibly complete improvement -- in the migraine pain and frequency.  This is true if the headaches are indeed migraine.  It is always my interest to confirm the diagnosis, in part to make sure there is nothing else causing the headaches that needs further investigation or to be treated differently.  I confer and collaborate with primary care and neurology consultants for evaluating the type of headache, and in reducing complicating factors like allergies, sinusitis, or sleep disorder.

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     If the headaches are a combination of tension and migraine, sinus and migraine, post-concussive and migraine, often the neurofeedback can help anyway.  Neurofeedback can help – along with comprehensive wellness measures -- the individual to become more resilient to migraine triggers.  Even if the diagnosis is migraine for the headache, it is still important that patients understand the neurofeedback may be helpful in the overall wellness and comprehensive approach to migraine.  I am not offering neurofeedback as a stand-alone treatment for migraine.

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    That said, it is entirely possible that patients can reduce or eliminate medications they are on solely for their migraines.  If the neurofeedback is helpful, and migraine frequency reduces or migraine pain ceases to occur, and auras dwindle, it is a natural course of events to discuss with the prescriber of the migraine medication whether it is time to taper the migraine medication.  Sometimes it is useful to continue the neurofeedback while the medication is being tapered, and if the migraine medication is a regular medication like an anticonvulsant, it can occur that it is essential to reduce the medication if side effects increase as the brain becomes more resilient to migraine triggers.  A better regulated brain may be more sensitive to side effects and this is a sign to consider medication reduction.  This is true with the psychoactive medications for depression and anxiety, or bipolar symptoms or attention symptoms as well, if the neurofeedback is reducing symptoms and the person is feeling better regulated emotionally.

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     My migraines were resolved by the time I added pirHEG neurofeedback to my practice.  pirHEG neurofeedback was developed by Jeff Carment PhD.  He specializes as a psychologist in working with patients with migraines, using psychological and biofeedback approaches.  The pirHEG is a wellness tool, not an FDA approved tool, and can be used along with the usual and comprehensive wellness approaches for improving migraine frequency and pain, as well as for reducing other stress related symptoms. 

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     While pirHEG helps with relaxation, it has a powerful impact on an individuals ability to reduce reactivity.  So patients struggling with over-reactivity to benign stimuli (rage, anxiety, irritability, impulsivity, stress-related eating, interpersonal issues) may have an opportunity to see those symptoms become less a problem.  This is because the target of pirHEG is aimed at improving brain behaviors related to the prefrontal cortex.  (The prefrontal cortex is that part of the brain that houses the executive functions such as impulse control, paying attention, staying organized, future planning, response inhibition, considering consequences of action, and has a strong impact on overall emotional regulation.)

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     Because of the way pirHEG addresses behaviors associated with executive function, and because the frontal lobe is vulnerable in concussions, pirHEG may be particularly useful in patients who have old concussions as a contributing factor to their headaches.  I have seen patients with old concussions respond as much and more to this form of neurofeedback as to medications and/or psychotherapy.  I would never say any neurofeedback replaces medications or psychotherapy, but I would say that neurofeedback and biofeedback may sometimes lead to a shorter course of the other treatments.  Or lower doses of medications.  (And I would repeat that any dose changes or changes in intensity or duration of psychotherapy would be made by the clinician providing those treatments.)

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     So I would encourage anyone with old concussions affecting mood or cognition, or causing headaches, or anyone with reactivity or migraines, and patients with brain fog not responding to typical medical attention, to consider a trial of neurofeedback.

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     To learn more about neurofeedback, read on my website about traditional eeg neurofeedback and about pirHEG neurofeedback.

     You may also check these resource links:

 

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