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The following is a summary of “Longitudinal neurofunctional changes in medication overuse headache patients after mindfulness practice in a randomized controlled trial (the MIND-CM study),” published in the June 2024 issue of Pain by Fedeli et al.

Patients with Chronic Migraine with Medication Overuse Headache (CM-MOH) are exploring mindfulness, which affects brain networks (Default Mode Network (DMN), Salience Network (SN), and Fronto-Parietal Network (FPN)) linked to pain management.

Researchers conducted a retrospective study to assess how adding mindfulness to usual pharmacological treatment in patients with CM-MOH impacted neurofunctional changes.

They involved patients diagnosed with CM-MOH without severe neurological or psychiatric comorbidities who were assigned to Treatment as Usual (TaU) or TaU plus mindfulness (TaU + MIND) groups. Neuroimaging and clinical assessments were performed before and one year after treatment. The DMN, SN, and FPN connectivity changes were compared between groups and correlated with clinical results. The vertex-wise analysis evaluated cortical thickness alterations.

The results showed that 177 patients with CM-MOH were randomly assigned to the TaU or TaU + MIND groups. About 34 patients (17 in each group) completed the neuroimaging follow-up. Both groups exhibited improvements in most clinical variables at follow-up, with only TaU + patients with MIND experiencing a significant reduction in headache frequency (P=0.028). After one year, TaU + patients with MIND demonstrated increased SN functional connectivity with the left posterior insula (P-FWE = 0.007) and sensorimotor cortex (P-FWE = 0.026). Additionally, greater SN-insular connectivity correlated with improved depression scores (r = -0.51, P=0.038) exclusively in patients with TaU + MIND. Longitudinal analysis revealed a cortical thickness increase in the insular cluster (P=0.015) and thicker anterior cingulate cortex in the TaU + MIND group (P-FWE = 0.02).

Investigators concluded that mindfulness practice in patients with CM-MOH increased brain connectivity patterns associated with pain modulation, body awareness, and cognitive processing of pain.

Source: thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-024-01803-5