Comparison of Four Biofeedback Treatments for Migraine Headache: Physiological and Headache Variables*

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Abstract
Migraine headache patients (42) participated in an appraisal of biofeedback for differential finger warming-forehead cooling, frontalis EMG (electromyogram) relaxation, alpha enhancement and vasoconstriction of the temporal scalp arteries. All patients provided 8 wk of baseline charting of headache, and then received 24 training sessions in one of the above conditions. Headache charting continued throughout training and for 8 mo. post-training. During the training period, measurements were taken of each biofeedback variable plus forehead temperature, heart rate, skin conductance and finger pulse amplitude. Analyses revealed that all groups had a significant reduction in number of headaches per week with no change in intensity, disability or length of headache. Physiological changes were consistently small and unrelated to headache outcome. A nonspecific effect for biofeedback is suggested with the likely candidates being a relaxation phenomenon or a cognitive explanation based upon perceived control.