Mindfulness Meditation Reduces Suffering In Chronic Migraineurs: Study

Migraine Meditation

Studies Show Meditation Helps Migraineurs (1)

A study conducted by researchers at Wake Forest Baptist Medical Center, Winston-Salem, NC, and Harvard Medical School in Boston, MA, examined 19 adults suffering from chronic migraines in order to find the effects of mindfulness meditation on those experiencing chronic headaches and to test the safety and feasibility of such a practice.

The findings of this study were published online in journal Headache.  Such a test was conducted mainly keeping in mind the hypothesis that stress-trigger in migraines could be addressed mindfulness meditation. As per lead author of the study, Rebecca Erwin Wells, assistant professor of neurology at Wake Forest Baptist, “Stress is a well-known trigger for headaches and research supports the general benefits of mind/body interventions for migraines, but there hasn’t been much research to evaluate specific standardized meditation interventions”. (2)

The study however demonstrated that mindfulness meditation did indeed help alleviate migraine pains and that they were a safe way to reduce the intensity and frequency of the migraines.

Mindfulness-based Stress Reduction or MBSR used yoga, mindfulness meditation and body awareness in a standardized 8-week program on the migraining volunteers. The migraineurs were divided into any of the 2 groups. They were then evaluated on disability, self-efficacy and mindfulness. After this was done, one group received conventional or mainstream migraine management care while the other group took part in the 8-week MBSR program. The MBSR program required the candidates to practice their mindfulness techniques for 45 minutes every day for at least 5 days a week. They were exposed to 1 instruction class every week as well. During this 8-week program all the participants noted how frequent their migraine episodes were, how long they lasted, how intense they were.

The researchers found that the patients who completed the MBSR program tended to have 1.4 fewer headaches per month that were less severe. Not only this, the episodes lasted less longer, were less disabling, the migraineurs felt a better sense of control over the events. Besides this, the program with its techniques proved safe as no adverse side effects were observed during the trial.

However, larger sample sizes and population with varied ethnicity, age groups, gender and socio-economic strata need to be studied for MBSR to be integrated into the mainstream and conventional treatment package for migraineurs.

According to Prof. Wells, “For the approximate 36 million Americans who suffer from migraines, there is a big need for non-pharmaceutical treatment strategies, and doctors and patients should know that MBSR is a safe intervention that could potentially decrease the impact of migraines.” (3)

SOURCES

  1. Image Credit: Woman Doing Yoga On Rock Stock Photo by Adamr; Free Digital Photos; Web September 2014; http://www.freedigitalphotos.net/images/Healthy_Living_g284-Woman_Doing_Yoga_On_Rock_p100414.html
  2. Migraine sufferers may find meditation helps; Medical News Today: Web September 2014; http://www.medicalnewstoday.com/articles/282441.php
  3. Meditation May Mitigate Migraine Misery;Wake Forest Baptist Medical Center – News & Media Resources; Web September 2014; http://www.wakehealth.edu/News-Releases/2014/Meditation_May_Mitigate_Migraine_Misery.htm

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More Frequent Migraines During Peri-menopause: Study

Menopause and Migraines

Study Shows Increase In Attacks During Menopause Transition (1)

A first of it’s kind study conducted by researchers at the University of Cincinnati Headache and Facial Pain Program shows conclusive proof that there is a recordable increase in the number of migraine episodes in women undergoing peri-menopause.

Peri-menopause is a phase of transitioning menopause. It could begin several months to years before actual menopause and is characterized by the woman experiencing some or all of symptoms such as irregular periods, fatigue, hot flashes, memory lapses, dry vagina, loss of libido, thinning of bones, incontinence, mood swings and breast tenderness etc. (2) All this is caused primarily due to the drop in the levels of female reproductive hormones such as estrogen and progesterone.

It was seen that headache instances rose during both peri-menopause and menopause when compared to pre-menopause. Pre-menopause was characterized by regular periods. As per Vincent T. Martin, M.D who is a professor of Medicine in the Department of Internal Medicine, University of Cincinnati, “Ours is the first study to demonstrate that the frequency of migraine attacks increases during the menopausal transition. The results of our study validate the belief by many women that their headaches worsen during the transition into menopause” (3)

Summary of the research study is as follows:

Particulars Numbers Comments
Total Women studied 3,603
Age range (women) 35 -65 years
Group classification
  1. High Frequency >10 episodes a month
  2. Low-Mod frequency < 10 attacks a month
Analysis classification
  1. 34% – premenopausal
  2. 35% – perimenopausal
  3. 30% – menopausal
  4. High Freq was 50-60% more common in perimenpausal and menopausal women

 

According to Richard B. Lipton, M.D., professor of Neurology and director of the Montefiore Headache Center at the Albert Einstein College of Medicine, “Given that migraines tend to worsen during menstruation, it may seem paradoxical that when periods become irregular during the peri-menopause or absent during menopause that headache become more frequent. We believe that both declining estrogen levels that occur at the time of menstruation as well as low estrogen levels that are encountered during the menopause are triggers of migraine in some women.” (3)

SOURCES

  1. Young Woman Suffering From Headache By Stock Images; FreeDigitalPhotos; Web August 2014; http://www.freedigitalphotos.net/images/young-woman-suffering-from-headache-photo-p171720
  2. Menopause Health Center – Perimenopause; Web MD; Web August 2014; http://www.webmd.com/menopause/guide/guide-perimenopause
  3. Women with Migraines Experience More Headaches During The Menopausal Transition; Science Daily News; Web August 2014; sciencedaily.com/releases/2014/06/140624215851.htm

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Episode Durations & Number Cutbacks With Diamine Oxidase Pills

swanson-ultra-daosin-30-capsules-300mcg

Diamine Oxidase Supplements May Reduce The Number, Duration, Intensity of Attacks (1)

Researchers have found that taking diamine oxidase supplements significantly reduces the duration of a migraine episode, especially if the migraine has been brought on by food triggers like cheese, caffeine, red wine etc. They have also observed that there exists a mildly indirect relation between to the total number migraine attacks itself in the mid to long run.

Diamine oxidase (DAO) is an amino acid that helps metabolise (break down) histamines released by our bodies. When we eat foods that we are allergic to (because our body cannot handle it’s digestion for any number of reasons specifically lack of appropriate enzymes) then the body perceives the situation as a threat to it’s well being. As a result it begins an immune response. In such as case histamines are released causing the capillary walls to give more access to proteins and white blood cells to engage with the pathogen/trigger/danger. This increase in histamine triggers migraines.

Histamines are also present in certain foods itself that when consumed raise histamine levels of the body and then trigger a migraine. Thus it is obvious that if migraineurs with food or weather triggers are administered an enzyme (such as DAO) that is responsible for the breakdown of histamines, migraine duration and number of attacks would reduce.

According to Joan Izquierdo, MD, from the Faculty of Health Sciences at the International University of Catalonia and the neurology service at Catalonia General Hospital in Barcelona, Spain, who studied men or women between ages 18 to 60 years old with an attack within the previous 6 months, “We diagnosed 137 patients who have a migraine, of who 119 showed deficits of the activity of the enzyme DAO, around 87% of the total patients that we have studied.” (2)

The study did not take into consideration alcoholism, psychiatric disorders, or a diagnosis of any disorder for which a treatment could be used as migraine prevention in the previous 1 month or those who could not consume pork-based products (DAO source).

Normal DAO enzyme activity is considered to be a score of 80. In the study, he found that there was a clear correlation between enzyme score and migraine episodes and intensities. Symptom scores rose progressively as enzyme activity dropped below 80 HDU/mL, with scores 50% to 120% higher in the 30-40 HDU/mL range compared with enzyme activity >80 HDU/mL.

Two groups were made and the control group was administered placebos and the other group was given the DAO supplements. The participant dosage was 2 capsules each after breakfast, lunch and dinner. To understand the pain factor, researchers noted the consumption of triptans by the participants. Those who were on placebos consumed 20% more triptans than those on DAO capsules. The diminished triptan use among patients receiving DAO suggests that the compound may have also reduced the intensity of pain during an attack, the researchers suggest.

Dr. Izquierdo also said, “Diamine oxidase supplementation has shown a significant reduction in crisis duration and a tendency toward a reduction in number of crises,” he said. “The treatment is [safe] because we don’t have any adverse events.” (3)

However, to be sure about the outcome of the research, a larger population needs to be studied cutting across ethnic groups and races. At it’s current stage, it is important thus to educate migraineurs of triggers whether they are of food, hunger, exposure to sun, sleep deprivation or weather and environmental conditions.

SOURCES:

  1. Swanson Ultra Daosin Diamine Oxidase; HealthMonthly.co.uk; Web October 2013; http://www.healthmonthly.co.uk/swanson_ultra_daosin_diamine_oxidase
  2. Migraine Attacks Shortened by Diamine Oxidase Supplements; MedScape.com; Web October 2013; http://www.medscape.com/viewarticle/811920
  3. 90% of Migraines Could Be Prevented with Enzyme; Universitat Internacional de Catalunya; Web October 2013; http://www.uic.es/en/news?id_noti=3273

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Sleep Quality Influences Migraine Frequency And Disability

Sleeping Woman - Migraine Blog

 

Sleep Quality Directly Effects How Often You Get Migraines (1)

Tests conducted by researchers at the University of Mississippi, U.S.A have shown a strong correlation between poor quality of sleep and the frequency of migraine episodes as well as the disabilities that go with the condition.

The Pittsburgh Sleep Quality Index (PSQI) was employed in the study which tested 78 migraineurs and 208 non-migraineurs who formed the control group.

The PSQI is a tool in the form of a scoring but subjective questionnaire developed by the Sleep Medicine Institute of the University of Pittsburgh. It has questions within it’s 7 broad components on which a patient is scored, viz;

  • Subjective Sleep Quality,
  • Sleep Latency,
  • Sleep Duration,
  • Habitual Sleep Efficiency,
  • Sleep Disturbance,
  • Use of Sleep Medicines,
  • Daytime Dysfunction.

Todd Smitherman and his team found that sleep quality was significantly worse for those experiencing episodic migraines than for those in the control group. The migraining group scored an average PSQI of 8.90 as compared to 6.63 in the control group. A PSQI score more than 5 is considered significantly bad.

Factors such as depression, anxiety were adjusted for the regression analysis calculations but still it accounted for 5.3% and 5.8% of unique variance in headache frequency and disability, respectively, which the researchers say is a modest but non-trivial amount. Even when depression and anxiety factors after poor sleep quality were included in the calculations the affective symptoms did not significantly improve these analysis models beyond that of sleep quality alone which made sleep quality almost an independent and very relevant factor in assessing headache frequencies and related disabilities.

As per Smitherman, “As such, sleep quality should be assessed preferentially to other sleep disturbance variables when subjective self-report measures of insomnia are used. In light of the present findings, conclusions from systematic reviews, and practice guidelines, the most potent means of improving sleep quality and insomnia among migraineurs is likely a treatment package that incorporates stimulus control and/or sleep restriction in addition to basic sleep hygiene education and management of comorbid psychiatric symptoms.” (2)

SOURCES:

  1. Image Credits: Freedigitalphotos.net; Tired Woman by Graur Codrin; Web August 2013; http://www.freedigitalphotos.net/images/agree-terms.php?id=10021635
  2. Sleep Quality A Key Contributor To Migraine Severity; MedWireNews.com (Springer Healthcare Limited); Web August 2013; http://www.medwirenews.com/44/104664/General_neurology/Sleep_quality_a_key_contributor_to_migraine_severity_.html
  •  Abstract of the research may be had at:

Sleep Disturbance and Affective Comorbidity Among Episodic Migraineurs; Wiley Online Library; Web August 2013; http://onlinelibrary.wiley.com/doi/10.1111/head.12168/abstract

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New Guidelines from American Academy of Neurology On Reduction of Migraine Frequency

New guidelines or strategy if you will, have been chalked out and released by scientists at the American Academy of Neurology in conjunction with the American Headache Society on the approach migraineurs should take to reduce the frequency of their attacks. These guidelines have been released just this week and basically are a little different from the previous guidelines in terms that they reduce the ranking of certain migraine drugs (such as Verapamil and Gabapentin) which were highly recommended in the last guidelines due to evidence gathered against them. In addition, the new guidelines are based on evidence-based research on a larger population than were done for the last set of guidelines covering various demographics – gender, races etc. (1)

Want Fewer Migraine Attacks? Follow a Preventative Regimen Everyday (2)

As per the neurologists, almost 38% of all migraineurs should follow a preventative strategy to reduce the number of their migraine episodes. But only a third of that percentage followed a daily preventative regimen with the rest of them only resorting to band aid approaches and tackling the pain once they are in the throes of a migraine attack or are expecting one within a few hours. The approaches they often took were such as were not proven effective in scientific testing before.

According to Mark Green, MD, director of the Headache Center at Mount Sinai School of Medicine, in New York, “What the guidelines do is pinpoint first-line treatments based on evidence and effectiveness.  If these guidelines are used widely, we will be able to up the odds of reducing headaches by 50 percent. Moreover, the stakes may be high if we undertreat migraines. Evidence is building to suggest that if we allow migraines to progress, the frequency of attacks may increase, and they may also become harder to treat” (3)

Here’s a quick look at what the evidence-based preventative guidelines suggests to migraineurs:

  1. First line prescription drugs must be taken on a daily basis to bring down the number and intensity of the attacks.
  2. Effective For Prevention: Anti-seizure medications Divalproex sodium, Sodium valproate, Topiramate, Metoprolol, Propranol, Tumolol.
  3. Effective Herbal Preparations: Butterbur / Petasites.
  4. Probably Effective: Nonsteroidal anti-inflammatory drugs or NSAIDS such as Fenoprofen, Ibuprofen, Ketoprofen, Naproxen, Naproxen Sodium, Subcutaneous histamine, Complementary treatments, Magnesium, Riboflavin, Feverfew.
  5. Found Not Effective: Anti-seizure drug lamotrigine was not effective in preventing migraine.

SOURCES:

  1. New Guidelines Assert That Daily Preventive Therapies Significantly Reduce Migraines; Newswise; April 2012; http://www.newswise.com/articles/view/588495/?sc=rsmn&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewswiseMednews+%28Newswise%3A+MedNews%29
  2. Image by Ambro; Freedigitalphotos.net; April 2012; http://www.freedigitalphotos.net/images/view_photog.php?photogid=1499
  3. New Guidelines: Treatments Can Help Prevent Migraine; American Academy of Neurology (AAN); April 2012; http://www.aan.com/press/index.cfm?fuseaction=release.view&release=1062

Video of the 2012 AAN Conference may be accessed at:

  1. 2012 AAN Press Conference: New Guidelines on Preventing Migraine Headache; YouTube.com; April 2012; http://www.youtube.com/watch?v=LoKPwq9JcKE&feature=g-upl&context=G2423319AUAAAAAAAAAA

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Migraines In Women

Continuing on the same note of my earlier post of 28th November, 2008 (De-mystifying Migraines In Women)….

Any aerobic activity done for a minimum of thrice a week for at least half an hour will tell positively on the texture of your migraines. Yes, you heard me right. I am talking of the frequency and intensity of migraines. It is banal to come across the ‘thrice a week for 30 minutes’ formula, from health articles on the web to the instructor in the gym who aim to pick on your fat. But it has other not so famous but greatly positive side effects, like the one I mentioned. There are 5 ways in which aerobic activities help us reduce our migraine intensity. 

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