title: Biofeedback-assisted relaxation in migraine headache: relationship to cerebral blood flow velocity in the middle cerebral artery.
abstract: OBJECTIVE
  To determine if migraineurs with aura respond differently to biofeedback/relaxation than those without aura and, if so, whether the variability in outcome can be explained by blood flow velocity. Background.-The relationship between cerebral blood flow velocity and treatment response to biofeedback/relaxation in migraine with and without aura is uncertain.
  
  
  METHODS
  Twenty migraineurs underwent 12 sessions of biofeedback/relaxation therapy, while 20 controls simply were told to relax on their own. Cerebral blood flow velocity was measured bilaterally in the middle cerebral artery with transcranial Doppler.
  
  
  RESULTS
  The biofeedback group showed significant (P <.05) reductions in pain, depression, and anxiety compared to the control group. Patients with and without aura did equally well. There were significant (P <.05) left to right blood flow velocity differences only in the migraine with aura group. Maximum blood flow velocities were significantly higher (P <.05) in the migraine with aura group than in the cohort without aura. There was an inverse correlation between indicators of anxiety and blood flow velocity, perhaps related to hyperventilation-induced constriction in the small vessels distal to the middle cerebral artery.
  
  
  CONCLUSIONS
  The positive treatment response to biofeedback/relaxation in migraine headache is not related to presence of aura, nor to changes in blood flow velocity, but may be associated with reduction in anxiety and depression.
authors.affiliation: Departments of Psychiatry, Medical College of Ohio, Toledo, Spain.
authors.forename: Sachinder
authors.initials: S
authors.lastname: Vasudeva
authors.forename: Alice L
authors.initials: AL
authors.lastname: Claggett
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Tietjen
authors.forename: Angele V
authors.initials: AV
authors.lastname: McGrady
mesh_terms: D000328:Adult; D001007:Anxiety; D001676:Biofeedback, Psychology / Q000379:methods; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000503:physiopathology*; D008881:Migraine Disorders / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D020325:Migraine with Aura / Q000503:physiopathology; D012063:Relaxation; D012064:Relaxation Therapy