The Effectiveness of Pain Neuroscience Education in a Practice Setting for Adults with Migraine

Abstract Pain Neuroscience Education (PNE) has established itself as a potential treatment for chronic pain. However, the evidence on the applicability of PNE in clinical practice for chronic pain syndromes such as migraine is limited. Investigation of the effectiveness of PNE in adults with migraine with regard to headache intensity, migraine and headache frequency and migraine-related impairments in activities of daily living. In this non-randomized hypothesis-generating pilot study, participants received PNE as a group intervention after an initial four-week control phase. Assessments took place before the control-phase, at baseline as well as 4 and 12 weeks after the intervention and were statistically analyzed. 14 participants were recruited. Headache intensity (NRS) decreased by a mean of 0.88 points after the intervention (median: 0.25; IQR: 1.63) and by 0.91 points during follow-up (median: 0,25; IQR: 1.38). Headache frequency decreased by 1.68 days after the intervention (median: 2; IQR: 4.5) and by 1.3 days during follow-up (median: 1; IQR: 2.5). Migraine days were reduced by 1.21 days both after the intervention and during follow-up (median: 1; IQR: 3.00; median: 1; IQR: 2.75). Anxiety, assessed using the total score of the Hospital Anxiety and Depression Scale (HADS-D/A), was reduced by 1.5 (median: 1.5; IQR: 3.5) after the intervention and by 2.07 (median: 3; IQR: 4) at follow-up. Depression, as assessed by the total score of the HADS-D/D, showed a mean difference of 1.33 (median: 0; IQR: 3) after the intervention and 1.46 (median: 1; IQR: 2) in the follow-up. Restrictions in activities of daily living (HIT-6) showed an improvement of 2.57 points after the intervention (median: 3; IQR: 5.75) and 4.69 points at follow-up (median: 4; IQR: 8). HDQ-G showed a post-intervention decrease of 8.79 points (median: 7; IQR: 6.25) and a follow-up decrease of 7.88 points (median: 5.5; IQR: 11.3). No adverse events were observed during the study. In adults with migraine, PNE leads to a clinically relevant improvement in anxiety and the restriction of activities of daily living, as well as to a moderate reduction in headache or migraine frequency and headache intensity. Further research is required to validate results. The study was registered with the German Register of Clinical Studies (DRKS00034262).