Chronic Migraine is a disabling condition that affects the 2% of migraine population. It is often associated with medication overuse that makes this condition very difficult to treat. The literature of the last decades confirm the efficacy of withdrawal for patients with medication overuse but it is also confirmed that patients have to be carefully followed in the last period after withdrawal to avoid relapses and to improve the clinical benefit of the therapeutic approach. It has been also reported how the clinical results can be improved when traditional therapies are combined with behavioral approaches in particular mindfulness, that help patient to become more conscious about their symptoms and able to manage pain without medication. Generally patients after withdrawal follow a specific prophylaxis for migraine, but also come weekly to the hospital for practicing mindfulness for 6 sessionsAs the emergency situation due to the Corona-virus pandemic phenomenon in Italy, patients will miss the possibility to come for the regular practice to the hospital: for this reason the investigator propose a small pilot study to enforce the use of technology for our patients so that they can continue to be followed in their therapeutic process. This preliminary study will be conducted on 25 patients that have been submitted to a withdrawal according to the standard procedure at our hospital and they will practice mindfulness daily by a standard session of 12 minutes on their smartphone recorded by the expert who generally manage their sessions at the hospital and also a weekly video-call to evaluate the clinical condition and to encourage to use strategies for pain management. This modality will allow the patients to continue their therapeutic process and to be followed regularly during the one year after withdrawal
Background and significance Chronic Migraine is a disabling condition that affects the 2% of
migraine population. It is often associated with medication overuse that makes this condition
very difficult to treat. The literature of the last decades confirm the efficacy of
withdrawal for patients with medication overuse. Also, patients need to be carefully followed
after withdrawal to avoid relapses in overuse and to improve the clinical benefit. It has
been also reported that the clinical results can be improved if traditional therapies are
combined with behavioral approaches in particular mindfulness, that help patients to become
more conscious about their symptoms and able to manage pain without medication.
This preliminary study will be performed because the emergency for Covid-19 with the
restrictions imposed will not allow patients. The literature of the last decades promote the
use of smart phone or telemedicine for clinical and therapeutic application with encouraging
results. Twenty five patients that have been submitted to a withdrawal according to the
standard procedure at our hospital will practice mindfulness daily by a standard session of
12 minutes on their smartphone recorded by the expert who generally manage their sessions at
the hospital. Also a weekly video-call to evaluate the clinical condition and to encourage to
use strategies for pain management will be scheduled.
This modality will allow the patients to continue their therapeutic process and to be
followed regularly during the one year after withdrawal
Behavioral: Mindfulness
Mindfulness by smartphone combined to video calls for clinical evaluation in patients with chronic migraine and medication overuse after withdrawal program
Inclusion Criteria:+
1. Years age >18 yrs
2. clinical diagnosis of Chronic Migraine with medication Overuse
3. withdrawal treatment at the Besta institute
4. written informed consent
Exclusion Criteria:
- none
UOC Neurologia 3
Milano, Italy
Investigator: Licia Grazzi, MD
Contact: 022394
licia.grazzi@istituto-besta.it
Licia Grazzi, MD
022394 - 2366
licia.grazzi@istituto-besta.it
Renato Mantegazza, MD
022394 - 2321
crc@istituto-besta.it