Comparison of four biofeedback treatments for migraine headache: physiological and headache variables

Forty-two migraine headache patients participated in an appraisal of biofeedback for differential finger warming--forehead cooling, frontalis EMG relaxation, alpha enhancement and vasoconstriction of the temporal scalp arteries. All patients provided 8 weeks 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 months posttraining. During the training period measures were made 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.