Mindfulness-Based Stress Reduction for the Treatment of Vestibular Migraine: A Prospective Pilot Study

Purpose The purpose of this study was to describe the implementation and efficacy of a mindfulness-based stress reduction (MBSR) program for treating dizziness symptoms in subjects with vestibular migraine (VM). Materials and methods A non-controlled prospective cohort study of 20 adult English-speaking patients with a diagnosis of VM was undertaken at a single tertiary referral center. A virtual platform was used to administer an eight-week-long MBSR course with required reading materials and weekly 2.5-hour guided meditation and instructional sessions. Pre- and post-MBSR scores on the Dizziness Handicap Index (DHI), Cognitive Failures Questionnaire (CFQ), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), VM Patient Assessment Tool and Handicap Inventory (VM-PATHI), Patient Reported Outcome Measure Information System (PROMIS) Global Physical and Mental Health Forms, and daily vertigo severity scores were collected. Results Twenty participants (100.0% female; 70.0% (n=14) White; with an average age of 46.7 years (SD 16.3), completed the study. The DHI, CFQ, PHQ-9, GAD-7, VM-PATHI, and PROMIS scores all improved significantly after MBSR treatment compared to prior to treatment (all questionnaires, p<0.01 except for CFQ; p=0.03). Mean daily vertigo scores did not change significantly over time in the 24-day lead-in period (adjusted r² = 0.03; p=0.54) but decreased significantly over the eight-week MBSR treatment period (adjusted r² = 0.32; p<0.001). Conclusions In this non-controlled, prospective pilot study, a MBSR program was highly effective for decreasing dizziness burden and improving measures of quality of life in subjects with VM. Future randomized controlled trials are warranted and forthcoming.