Immediate Cognitive and Interoceptive Benefits of Yoga-Based Visual Respiratory Biofeedback in Migraine: A Randomized...

Migraine without aura is associated with autonomic dysregulation and cognitive deficits, particularly in visuospatial cognition and interoception. Yoga-based interventions have shown promise in enhancing autonomic and cognitive functions. This study aimed to evaluate the immediate effects of a novel yoga-based visual respiratory biofeedback (VRB) intervention on visuospatial cognition and interoception in individuals with migraine without aura. A total of 102 individuals were screened using clinical history, Migraine Screening Questionnaire (MSQ), and Montreal Cognitive Assessment (MoCA). Sixty-four participants who met the eligibility criteria were recruited and randomized in a 1:1 ratio into two groups: (1) the experimental group (n = 32), which received 20 min of yogic VRB intervention involving alternate nostril yogic breathing (ANYB), and (2) the control group (n = 32), which watched a 20-minute documentary as a neutral visual stimulus. Visuospatial cognition was assessed using the Corsi Block Tapping Task, while interoception was measured with the Heartbeat Counting Task. Assessments were conducted immediately before and after the intervention. Linear Mixed Models (LMM) were used for statistical analysis to account for repeated measures. The VRB intervention significantly improved both visuospatial cognition and interoceptive accuracy in the experimental group compared to the control group. The experimental group showed a significant increase in Corsi span (t = - 3.97, df = 62, 95% CI [- 0.7, - 0.23], p < 0.001), indicating enhanced spatial working memory. In contrast, the control group showed no significant change in Corsi span. Both the groups showed significant increase in Corsi total score (t = 3.5, df = 62, 95% CI [1.87, 6.41], p < 0.001) after intervention, with no significant difference in group*time interaction. Furthermore, the experimental group demonstrated greater improvement in interoceptive accuracy compared to the control group, as indicated by increased scores derived from the Heartbeat Counting Task (t = - 8.59, df = 62, 95% CI [- 0.21, - 0.13], p < 0.001). The results suggest that a single session of the yoga-based VRB intervention effectively enhances both visuospatial cognitive performance and interoceptive accuracy in individuals with migraine without aura. These findings indicate that VRB may serve as a promising therapeutic tool for modulating autonomic and cognitive functions in migraine patients, potentially reducing the impact of migraine-related cognitive and interoceptive impairments. Future studies should explore the integration of this therapy with conventional care, its long-term effects and their applicability to broader populations.