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Identification of neural and psychophysical predictors of headache reduction after cognitive behavioral therapy in adolescents with migraine

Pain Jan 27, 2021

Nahman-Averbuch H, Schneider VJ, Chamberlin LA, et al. - In adolescents with migraine, experts explored whether baseline brain function and amygdalar connectivity (assessed by functional magnetic resonance imaging) or pain modulation capacities (evaluated by the conditioned pain modulation [CPM]) response, can predict a decrease in headache days after cognitive behavioral therapy (CBT). Eight weekly CBT sessions were completed by migraine patients (n = 20; age range 10-17 years). In the trapezius and the leg, the CPM response was examined. A larger reduction in headache days after CBT was associated with a less efficient response to CPM to the trapezius but not to the leg before CBT. This study showed that after CBT, headache reduction was linked to right amygdala baseline connectivity with frontal and sensorimotor regions as well as baseline pain modulation capacities. Such results indicate that clinical improvements may be correlated with individual variations in brain function and pain modulation and assist in evaluating CBT responsiveness.

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