Behavioural treatment programme contributes to normalization of contingent negative variation in children with migraine

Background: Migraine is a disorder of central information processing which may be characterized by increased amplitudes and reduced habituation of evoked and event-related potentials. In this pilot study, special behavioural training of habituation to aversive stimuli (MIPAS-Family = Migraine Patient Seminar for Families) was developed and proven effective in children suffering from migraine without aura. Methods: 13 children with migraine participated in the MIPAS-Family programme and 13 other children with migraine were treated with biofeedback. The influence of both treatments on abnormal cortical information processing in migraine was assessed using recordings of the contingent negative variation (CNV), an event-related slow cortical potential. Results: Both MIPAS training and biofeedback caused an equal reduction of migraine frequency and severity. However, MIPAS treatment was associated with a significant increase in iCNV habituation. Changes in the clinical course of migraine correlated positively with normalization of habituation: the greater the reduction in headache frequency, the greater the increase in CNV habituation was. These effects were not observed in the biofeedback group. Conclusions: This study demonstrates that the specific treatment programme which was evolved from knowledge of pathogenetic mechanisms of migraine influences central information processing and leads to a clinical effect.

[1]  F. Andrasik,et al.  Behavioral Assessment and Treatment of Pediatric Headache , 2006, Behavior modification.

[2]  M. Timsit-Berthier,et al.  Contingent negative variation in headache , 1986, Annals of neurology.

[3]  Peter J. Goadsby,et al.  A Report on the Journal 2004 , 2004 .

[4]  U. Stephani,et al.  Migraine in childhood – are periodically occurring migraine attacks related to dynamic changes of cortical information processing? , 2000, Neuroscience Letters.

[5]  J. Schoenen,et al.  Evoked potentials and transcranial magnetic stimulation in migraine: published data and viewpoint on their pathophysiologic significance , 2003, Clinical Neurophysiology.

[6]  M. Guido,et al.  Effects of topiramate and levetiracetam vs placebo on habituation of contingent negative variation in migraine patients , 2008, Neuroscience Letters.

[7]  Peter Kropp,et al.  Prediction of migraine attacks using a slow cortical potential, the contingent negative variation , 1998, Neuroscience Letters.

[8]  U. Stephani,et al.  Developmental changes of the contingent negative variation in migraine and healthy children , 2009, The Journal of Headache and Pain.

[9]  F. Andrasik,et al.  Biofeedback-Assisted Relaxation Training for Young Adolescents with Tension-Type Headache: A Controlled Study , 1998, Cephalalgia : an international journal of headache.

[10]  L. Metsähonkala,et al.  Force production and EMG activity of neck muscles in adolescent headache , 2008, Disability and rehabilitation.

[11]  U. Stephani,et al.  MIPAS-Family—evaluation of a new multi-modal behavioral training program for pediatric headaches: clinical effects and the impact on quality of life , 2010, The Journal of Headache and Pain.

[12]  M. Siniatchkin,et al.  Clinical efficacy and central mechanisms of cyclandelate in migraine: a double-blind placebo-controlled study. , 1998, Functional neurology.

[13]  Winfried Rief,et al.  Meta-analysis of biofeedback for tension-type headache: efficacy, specificity, and treatment moderators. , 2008, Journal of consulting and clinical psychology.

[14]  M. Timsit-Berthier,et al.  Contingent Negative Variation in Migraine , 1990, Headache.

[15]  J. Olesen The International Classification of Headache Disorders , 2008, Headache.

[16]  U. Stephani,et al.  Self-regulation of Slow Cortical Potentials in Children with Migraine: An Exploratory Study , 2000, Applied psychophysiology and biofeedback.

[17]  J. Schoenen Neurophysiological features of the migrainous brain , 2006, Neurological Sciences.

[18]  U. Stephani,et al.  Slow Cortical Potentials in Migraine Families , 2000, Cephalalgia : an international journal of headache.

[19]  F. Andrasik,et al.  Behavioral Management of Recurrent Headache: Three Decades of Experience and Empiricism , 2002, Applied psychophysiology and biofeedback.

[20]  B. Rockstroh,et al.  Slow potentials of the cerebral cortex and behavior. , 1990, Physiological reviews.

[21]  F. Resch,et al.  Stereotyped topography of different elevated contingent negative variation components in children with migraine without aura points towards a subcortical dysfunction , 2007, PAIN.

[22]  T. Bartsch Migraine and the neck: New insights from basic data , 2005, Current pain and headache reports.

[23]  M. Siniatchkin,et al.  Relationship between Precipitating Agents and Neurophysiological Abnormalities in Migraine , 2006, Cephalalgia : an international journal of headache.

[24]  Stephan Bender,et al.  How do children prepare to react? Imaging maturation of motor preparation and stimulus anticipation by late contingent negative variation , 2005, NeuroImage.

[25]  H. Critchley,et al.  Changes in Cortical Potential Associated With Modulation of Peripheral Sympathetic Activity in Patients With Epilepsy , 2009, Psychosomatic medicine.

[26]  P. Kropp,et al.  Is Increased Amplitude of Contingent Negative Variation in Migraine Due to Cortical Hyperactivity or to Reduced Habituation? , 1993, Cephalalgia : an international journal of headache.

[27]  U. Stephani,et al.  Migraine and Asthma in Childhood: Evidence for Specific Asymmetric Parent-Child Interactions in Migraine and Asthma Families , 2003, Cephalalgia : an international journal of headache.

[28]  E Donchin,et al.  A new method for off-line removal of ocular artifact. , 1983, Electroencephalography and clinical neurophysiology.

[29]  K. Widaman,et al.  CHAPTER 5 – An Evaluation of Statistical Strategies to Analyze Repeated-Measures Data , 1984 .

[30]  W. Gerber,et al.  MIPAS-Family – Entwicklung und Evaluation eines verhaltensmedizinischen Programms zur Behandlung kindlicher Kopfschmerzen , 2008, Verhaltenstherapie.

[31]  M. Timsit-Berthier,et al.  Effects of β blockade on contingent negative variation in migraine , 1987, Annals of neurology.

[32]  M. Siniatchkin,et al.  Are the Periodic Changes of Neurophysiological Parameters During the Pain-Free Interval in Migraine Related to Abnormal Orienting Activity? , 2000, Cephalalgia : an international journal of headache.

[33]  E. Blanchard,et al.  Psychophysiological comparisons of three kinds of headache subjects during and between headache states: analysis of post-stress adaptation periods. , 1985, Journal of psychosomatic research.

[34]  E. Blanchard,et al.  Behavioral and prophylactic pharmacological intervention studies of pediatric migraine: an exploratory meta-analysis , 1995, Pain.

[35]  U. Stephani,et al.  Central Mechanisms of Controlled-Release Metoprolol in Migraine: A Double-Blind, Placebo-Controlled Study , 2007, Cephalalgia : an international journal of headache.

[36]  Ian Wickramasekera PhD How Does Biofeedback Reduce Clinical Symptoms and Do Memories and Beliefs Have Biological Consequences? Toward a Model of Mind-Body Healing , 1999, Applied psychophysiology and biofeedback.

[37]  J. Olesen,et al.  Quantitative surface EMG of pericranial muscles in headache. A population study. , 1994, Electroencephalography and clinical neurophysiology.

[38]  M. Siniatchkin,et al.  How the brain anticipates an attack: a study of neurophysiological periodicity in migraine. , 1999, Functional neurology.

[39]  Bjørn Ellertsen,et al.  Psychophysiologic Response Patterns in Migraine Before and After Temperature Biofeedback: Prediction of Treatment Outcome , 1987, Cephalalgia : an international journal of headache.

[40]  Ulrich Stephani,et al.  Neurophysiological reactivity before a migraine attack , 2006, Neuroscience Letters.

[41]  J. Passchier,et al.  The effect of stress imagery on arousal and its implications for biofeedback of the frontalis muscles , 1981, Biofeedback and self-regulation.

[42]  C. M Gómez,et al.  Preparatory visuo-motor cortical network of the contingent negative variation estimated by current density , 2003, NeuroImage.