Acceptance-Commitment Therapy for Women with Episodic Migraine: A Pilot Randomized Trial

Area of Science:

• Neurology
• Psychology
• Clinical Trials

Background:

• Biobehavioral treatments are emerging as preventive therapies for migraine.
• Acceptance and commitment therapy (ACT), a psychological flexibility intervention, shows promise for chronic pain but is understudied for migraine.
• Episodic migraine affects numerous women, necessitating effective management strategies.

Purpose of the Study:

• To conduct a pilot randomized controlled trial (RCT) of ACT for episodic migraine in adult women.
• To assess the feasibility, retention, and adherence of an 8-week virtual ACT intervention.
• To evaluate the impact of ACT on migraine frequency and disability.

Main Methods:

• A pilot RCT comparing ACT to enhanced usual care (EUC) in 54 women with episodic migraine.
• ACT involved eight weekly virtual sessions.
• Primary outcomes included recruitment success, retention, and adherence; secondary outcomes were changes in migraine days and Migraine Disability Assessment (MIDAS) scores.

Main Results:

• Recruitment goals were surpassed, with 54 women enrolled in 15 months.
• Completion rates for migraine logs and questionnaires were lower than anticipated, particularly during the COVID-19 pandemic.
• While ACT showed a trend towards decreased migraine days initially, differences between groups were not sustained at follow-up. Both groups reported similar reductions in MIDAS scores.

Conclusions:

• Recruitment for a large-scale ACT trial for episodic migraine is feasible.
• Remote data collection and participant burden presented challenges, impacting completion rates.
• Future research should aim to reduce participant burden and streamline study procedures for better data collection.