Nervenheilkunde 2016; 35(07/08): 502-515
DOI: 10.1055/s-0037-1616413
Leitlinie
Schattauer GmbH

Entspannungsverfahren und verhaltenstherapeutische Interventionen zur Behandlung der Migräne

Leitlinie der Deutschen Migräne- und KopfschmerzgesellschaftRelaxation therapy and cognitive behavioural therapy for treatment of migraineGuideline of the German migraine headache Society
P. Kropp
1   Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock
,
B. Meyer
1   Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock
,
T. Dresler
2   Klinik für Psychiatrie und Psychotherapie, Universität Tübingen
3   Graduiertenschule LEAD, Universität Tübingen
,
G. Fritsche
4   Klinik für Neurologie, Universitätsklinikum Essen
,
C. Gaul
5   Migräne und Kopfschmerz Klinik Königstein, Königstein im Taunus
,
U. Niederberger
6   Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
,
S. Förderreuther
7   Neurologie, Ludwig-Maximilians-Universität München
,
V. Malzacher
8   Neurologische Praxis, Reutlingen
,
T. P. Jürgens
9   Klinik und Poliklinik für Neurologie, Universitätsmedizin Rostock
,
M. Marziniak
10   Klinik für Neurologie Zentrum für Neurologische Intensivmedizin kbo-Isar-Amper-Klinikum München-Ost
,
A. Straube
7   Neurologie, Ludwig-Maximilians-Universität München
› Author Affiliations
Further Information

Publication History

eingegangen am: 10 April 2016

angenommen am: 21 April 2016

Publication Date:
31 January 2018 (online)

Zusammenfassung

Neben medikamentösen und interventionellen Verfahren bestehen zur Behandlung der Migräne nicht medikamentöse Möglichkeiten, die überwiegend der Verhaltenstherapie entstammen. In der Zusammenschau kann dabei aufgezeigt werden, dass bereits eine ausführliche Beratung des Patienten zu positiven Effekten in der Migränehäufigkeit führen kann. Entspannungsverfahren (insbesondere die Progressive Muskelrelaxation nach Jacobson), Ausdauersport und verschiedene Arten von Biofeedback sind neben der Anwendung kognitiver Verhaltenstherapie in der Behandlung der Migräne effektiv. Die Kombination der Behandlungsverfahren selbst mit einer prophylaktischen medikamentösen Therapie führt zu zusätzlichen positiven Effekten.

Summary

Besides pharmacological and interventional treatment options, non-pharmacological options deriving from behavioural approaches may be helpful in the treatment of migraine. Even consulting a patient is able to reduce the frequency of migraine attacks. Relaxation therapy (in particular progressive muscle relaxation), endurance sports, and biofeedback of different modalities as well as cognitive behavioural therapy are effective in the prophylactic treatment of migraine. The combination of these treatment options with prophylactic pharmacological treatment increases these positive effects.

 
  • Literatur

  • 1 Altieri M, Di Giambattista R, Di Clemente L, Fagiolo D, Tarolla E, Mercurio A, Vicenzini E, Tarsitani L, Lenzi GL, Biondi M, Di Piero V. Combined pharmacological and short-term psychodynamic psychotherapy for probable medication overuse headache: a pilot study. Cephalalgia 2009; 29: 293-299.
  • 2 Andrasik F. Behavioral treatment of headaches: extending the reach. Neurol Sci 2014; 33 (Suppl. 01) S127-130
  • 3 Andrasik F. Behavioural treatment approaches to chronic headache. Neurol Sci 2003; 24: 80-85.
  • 4 Andrasik F. What does the evidence show? Efficacy of behavioural treatments for recurrent headaches in adults. Neurol Sci 2007; 28 (Suppl. 02) S70-S77.
  • 5 Andrasik F. Biofeedback in headache: An overview of approaches and evidence. Cleve Clin J Med 2010; 77: 72-76.
  • 6 Anttila V. et al. Genome-wide meta-analysis identifies new susceptibility loci for migraine. Nat Genet 2013; 45: 912-917.
  • 7 Attfield M, Peck DF. Temperature self-regulation and relaxation with migraine patients and normals. Behav Res Ther 1979; 17: 591-595.
  • 8 Bernstein DA, Borkovec TD. Progressive Relaxation Training: A manual for the helping professions. Champaign: IL Research Press; 1973
  • 9 Bernstein DA, Borkovec TD. Entspannungstraining. Handbuch der Progressiven Muskelentspannung nach Jacobson. Stuttgart: Klett-Cotta; 1979
  • 10 Bigal ME, Lipton RB. Excessive opioid use and the development of chronic migraine. Pain 2009; 142: 179-182.
  • 11 Blanchard EB, Andrasik F, Ahles TA, Teders SJ, Okeefe D. Migraine and tension headache – a meta-analytic review. Behavior Therapy 1980; 11: 613-631.
  • 12 Blanchard EB, Theobald DE, Williamson DA, Silver BV, Brown DA. Temperature biofeedback in the treatment of migraine headaches: a controlled evaluation. Arch Gen Psychiatry 1978; 35: 581-588.
  • 13 Blumenfeld A, Tischio M. Center of excellence for headache care: group model at kaiser permanente. Headache 2003; 43: 431-440.
  • 14 Busch V, Gaul C. Sport bei Migräne. Schmerz 2008; 22: 137-147.
  • 15 Buse DC, Manack A, Serrano D, Turkel C, Lipton RB. Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers. J Neurol Neurosurg Psychiatry 2010; 81: 428-432.
  • 16 Campbell JK, Penzien BD, Wall EM. Evidence-based guidelines for migraine headaches: behavioural and physical treatments. American Academy of Neurology website. www.aan.com/professionals/practice/pdfs/gl0089.pdf
  • 17 Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988; (08) (Suppl. 07) 1-96
  • 18 Daly EJ, Donn PA, Galliher MJ, Zimmerman JS. Biofeedback applications to migraine and tension headaches: a double-blinded outcome study. Biofeedback Self Regul 1983; 8: 135-152.
  • 19 Darabaneanu S, Overath CH, Rubin D, Lüthje S, Sye W, Niederberger U, Gerber WD, Weisser B. Aerobic exercise as a therapy option for migraine: a pilot study. Int J Sports Med 2011; 32: 455-460.
  • 20 Diener HC, Weimar C. Leitlinien für Diagnostik und Therapie in der Neurologie, herausgegeben von der Kommission „Leitlinien“ der Deutschen Gesellschaft für Neurologie. Stuttgart: Thieme; 2012
  • 21 Dindo L, Recober A, Marchman J, O’Hara MW, Turvey C. One-day behavioral intervention in depressed migraine patients: effects on headache. Headache 2014; 54: 528-538.
  • 22 Dittrich SM, Günther V, Franz G, Burtscher M, Holzner B, Kopp M. Aerobic exercise with relaxation: influence on pain and psychological well-being in female migraine patients. Clin J Sport Med 2008; 18: 363-365.
  • 23 D’Souza PJ, Lumley MA, Kraft CA, Dooley JA. Relaxation training and written emotional disclosure for tension or migraine headaches: a randomized, controlled trial. Ann Behav Med 2008; 36: 21-32.
  • 24 Ducros A, Joutel A, Vahedi K, Cecillon M, Ferreira A, Bernard E, Verier A, Echenne B, Lopez de Munain A, Bousser MG, Tournier-Lasserve E. Mapping of a second locus for familial hemiplegic migraine to 1q21-q23 and evidence of further heterogeneity. Ann Neurol 1997; 42: 885-890.
  • 25 Eccleston C, Fisher E, Craig L, Duggan GB, Rosser BA, Keogh E. Psychological therapies (Internet-delivered) for the management of chronic pain in adults. Cochrane Database Syst Rev 2014; 2: CD010152.
  • 26 Färkkilä M, Diener HC, Géraud G. et al. Efficacy and tolerability of lasmiditan, an oral 5-HT(1F) receptor agonist, for the acute treatment of migraine: a phase 2 randomised, placebo-controlled, parallel-group, dose-ranging study. Lancet Neurol 2012; 11: 405-413
  • 27 Fernandez E, Boyle GJ. Affective and evaluative descriptors of pain in the McGill pain questionnaire: reduction and reorganization. J Pain 2002; 3: 70-77.
  • 28 French DJ, Holroyd KA, Pinell C, Malinoski PT, O´Donnell F, Hill KR. Perceived self-efficacy and headache-related disability. Headache 2000; 40: 647-656.
  • 29 Frettlöh J, Franz C, Jäkle C. et al. Das Manual. In: Basler HD, Kröner-Herwig B. (Hrsg.) Psychologische Therapie bei Kopf- und Rückenschmerzen. München: Quintessenz; 1998
  • 30 Fritsche G, Frettlöh J, Hüppe M, Dlugaj M, Matatko N, Gaul C, Diener HC. Study Group. Prevention of medication overuse in patients with migraine. Pain 2010; 151: 404-413.
  • 31 Fritsche G, Kröner-Herwig B, Kropp P, Niederberger U, Haag G. Psychologische Therapie der Migräne. Schmerz 2014; 27: 263-274.
  • 32 Gaul C, Totzeck A, Kraus U, Straube A. Kopfschmerz und Sport. Akt Neurol 2010; 39: 254-260.
  • 33 Gaul C, Brömstrup J, Fritsche G, Diener HC, Katsarava Z. Evaluating integrated headache care: a one-year follow-up observational study in patients treated at the Essen headache centre. BMC Neurol 2011; 11: 124.
  • 34 Goslin RE, Gray RN, McCrory DC, Penzien D, Rains J, Hasselblad V. Behavioral and physical treatments for migraine headache. AHRQ Technical Reviews. 1999 No. 2.2
  • 35 Göbel H. Innovative Versorgungsformen in der Schmerztherapie. Schmerz 2013; 27: 120-122.
  • 36 Grazzi L, Andrasik F, D’Amico D, Leone M, Usai S, Kass SJ, Bussone G. Behavioral and pharmacologic treatment of transformed migraine with analgesic overuse: outcome at 3 years. Headache 2002; 42: 483-490.
  • 37 Grazzi L, Usai S, Prunesti A, Bussone G, Andrasik F. Behavioral plus pharmacological treatment versus pharmacological treatment only for chronic migraine with medication overuse after day-hospital withdrawal. Neurol Sci 2009; (30) (Suppl. 01) S117-119
  • 38 Haddock CK, Rowan AB, Andrasik F, Wilson PG, Talcott GW, Stein RJ. Home-based behavioral treatments for chronic benign headache: a meta-analysis of controlled trials. Cephalalgia 1997; 17: 113-118.
  • 39 Harpole L, Samsa G, Jurgelski A, Shipley JL, Bernstein A, Matchar DB. Headache management program improves outcome for chronic headache. Headache 2003; 43: 715-724.
  • 40 Hay KM, Madders J. Migraine treated by relaxation therapy. J R Coll Gen Pract 1971; 21: 664-669.
  • 41 Hayes SC, Barnes-Holmes D, Roche B. (eds). Relational Frame Theory: A Post-Skinnerian account of human language and cognition. New York: Plenum Press; 2001
  • 42 Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders. Cephalalgia 2013; 33: 629-808.
  • 43 Holroyd KA, Andrasik F. A cognitive-behavioral approach to recurrent tension and migraine headache. In: Kendall PC. (ed.) Advances in cognitive-behavioral research and therapy. New York: Academic; 2013: 275-320
  • 44 Holroyd KA, Cordingley GE, Pingel JD, Jerome A, Theofanous AG, Jackson DK, Leard L. Enhancing the effectiveness of abortive therapy: a controlled evaluation of self-management training. Headache 1989; 29: 14-15.
  • 45 Holroyd KA, Penzien DB. Pharmacological versus non-pharmacological prophylaxis of recurrent migraine headache: a meta-analytic review of clinical trials. Pain 1990; 42: 1-13.
  • 46 Holroyd KA, France JL, Cordingley GE, Rokicki LA, Kvaal SA, Lipchik GL, McCool HR. Enhancing the effectiveness of relaxation-thermal biofeedback training with propranolol hydrochloride. J Consult Clin Psychol 1995; 63: 327-330.
  • 47 Holroyd KA, Cottrell CK, O’Donnell FJ, Cordingley GE, Drew JB, Carlson BW, Himawan L. Effect of preventive (beta blocker) treatment, behavioural migraine management, or their combination on outcomes of optimised acute treatment in frequent migraine: randomised controlled trial. BMJ 2010; 341: c4871.
  • 48 Jacobson E. Progressive Relaxation. Chicago: University of Chicago Press; 1938
  • 49 Janssen K, Neutgens J. Autogenic training and progressive relaxation in the treatment of three kinds of headache. Behav Res Ther 1986; 24: 199-208.
  • 50 Kang EH, Park JE, Chung CS, Yu BH. Effect of biofeedback-assisted autogenic training on headache activity and mood states in Korean female migraine patients. J Korean Med Sci 2009; 24: 936-940.
  • 51 Katsarava Z, Schneeweiss S, Kurth T, Kroener U, Fritsche G, Eikermann A, Diener HC, Limmroth V. Incidence and predictors for chronicity of headache in patients with episodic migraine. Neurology 2004; 62: 788-790.
  • 52 Kindelan-Calvo P, Gil-Martinez A, Paris-Alemany A, Pardo-Montero J, Munoz-Garcia D, Angulo-Diaz-Parreno S, La Touche R. Effectiveness of therapeutic patient edication for adults with migraine. A systematic review and meta-analysis of randomized controlled trials. Pain Medicine 2014; 15: 1619-1636.
  • 53 Kleiboer A, Sorbi M, van Silfhout M, Kooistra L, Passchier J. Short-term effectiveness of an online behavioral training in migraine self-management: a randomized controlled trial. Behav Res Ther 2014; 61: 61-69.
  • 54 Koseoglu E, Yetkin MF, Ugur F, Bilgen M. The role of exercise in migraine treatment short title: exercise in migraine. J Sports Med Phys Fitness 2015; 55: 1029-1036.
  • 55 Kropp P, Niederberger U. Theoretische Konzepte und Wirkmechanismen. In: Martin A, Rief W. (Hrsg). Wie wirksam ist Biofeedback?. Bern: Huber; 2008: 43-49
  • 56 Kropp P, Reuter U. Klinik und Pathogenese der Migräne. In: Fritsche G, Gaul C. (Hrsg.). Multimodale Schmerztherapie bei chronischen Kopfschmerzen. Stuttgart: Thieme; 2013: 42-44
  • 57 Kropp P, Klinger R, Dresler T. Die Erwartungshaltung – Migräneauslöser Nummer 1?. MMW 2015; 157: 62-66.
  • 58 Kubik A, Biedroń A. Neurofeedback therapy in patients with acute and chronic pain syndromes – literature review and own experience. Przegl Lek 2013; 70: 440-442.
  • 59 Le H, Tfelt-Hansen P, Skytthe A, Kyvik KO, Olesen J. Association between migraine, lifestyle and socioeconomic factors: a population-based cross-sectional study. J Headache Pain 2011; 12: 157-172.
  • 60 Lea RA, Shepherd AG, Curtain RP, Nyholt DR, Quinlan S, Brimage PJ, Griffiths LR. A typical migraine susceptibility region localizes to chromosome 1q31. Neurogenetics 2002; 4: 17-22.
  • 61 Lemstra M, Stewart B, Olszynski W. Effectiveness of multidisziplinary intervention in the treatment of migraine: a randomized clinical trial. Headache 2002; 42: 845-854.
  • 62 Lipton RB, Bigal ME. Ten lessons on the epidemiology of migraine. Headache 2007; (47) (Suppl. 01) S2-9
  • 63 Lisspers J, Öst LG. Long-term follow-up of migraine treatment: do the effects remain up to six years?. Behav Res Ther 1990; 28: 313-322.
  • 64 Litt MD. Mediating factors in non-medical treatment for migraine headache: toward an interactional model. J Psychosom Res 1986; 30: 505-519.
  • 65 Lu SR, Fuh JL, Chen WT, Juang KD, Wang SJ. Chronic daily headache in Taipei, Taiwan: prevalence, follow-up and outcome predictors. Cephalalgia 2001; 21: 980-986.
  • 66 Lüking M, Martin A. Entspannung, Imagination, Biofeedback und Meditation. In: Kröner-Herwig B, Frettlöh J, Klinger R, Nilges P. (Hrsg). Schmerzpsychotherapie. Berlin: Springer; 2010: 566-584
  • 67 Manack A, Buse DC, Serrano D, Turkel CC, Lipton RB. Rates, predictors, and consequences of remission from chronic migraine to episodic migraine. Neurology 2011; 76: 711-718.
  • 68 Marcus DA, Scharff L, Mercer S, Turk DC. Nonpharmacological treatment for migraine: incremental utility of physical therapy with relaxation and thermal biofeedback. Cephalalgia 1998; 18: 266-272.
  • 69 Martin PR, Forsyth MR, Reece J. Cognitive-behavioral therapy versus temporal pulse amplitude biofeedback training for recurrent headache. Behav Ther 2007; 38: 350-363.
  • 70 Martin PR, Reece J, Callan M, MacLeod C, Kaur A, Gregg K, Goadsby PJ. Behavioral management of the triggers of recurrent headache: a randomized controlled trial. Behav Res Ther 2014; 61: 1-11.
  • 71 Messlinger K, Lennerz JK, Eberhardt M, Fischer MJ. CGRP and NO in the trigeminal system: mechanisms and role in headache generation. Headache 2012; 52: 1411-1427.
  • 72 Mitchell KR, Mitchell DM. Migraine: an exploratory treatment application of programmed behaviour therapy techniques. J Psychosom Res 1971; 15: 137-157.
  • 73 Moshkani Farahani D, Tavallaie SA, Ahmadi K, Fathi Ashtiani A. Comparison of neurofeedback and transcutaneous electrical nerve stimulation efficacy on treatment of primary headaches: a randomized controlled clinical trial. Iran Red Crescent Med J 2014; 16: e17799.
  • 74 Mullally WJ, Hall K, Goldstein R. Efficacy of biofeedback in the treatment of migraine and tension type headaches. Pain Physician 2009; 12: 1005-1011.
  • 75 Negro A, Martelletti P. Chronic migraine plus medication overuse headache: two entities or not?. J Headache Pain 2011; 12: 593-601.
  • 76 Nestoriuc Y, Martin A, Rief W, Andrasik F. Biofeedback treatment for headache disorders: a comprehensive efficacy review. Appl Psychophysiol Biofeedback 2008; 33: 125-140.
  • 77 Odawara M, Hashizume M, Yoshiuchi K, Tsuboi K. Real-time assessment of the effect of biofeedback therapy with migraine: A pilot study. Int J Behav Med 2015; 22: 748-754.
  • 78 Ottman R, Lipton RB. Comorbidity of migraine and epilepsy. Neurology 1994; 44: 2105-2110.
  • 79 Overath CH, Darabaneanu S, Evers MC, Gerber WD, Graf M, Keller A, Niederberger U, Schäl H, Siniatchkin M, Weisser B. Does an aerobic endurance programme have an influence in information processing in migraineurs?. J Headache Pain 2010; 15: 11.
  • 80 Paulley JW, Haskell DA. The treatment of migraine without drugs. J Psychosom Res 1975; 19: 367-374.
  • 81 Penzien DB, Rains JC, Andrasik F. Behavioral management of recurrent headache: three decades of experience and empiricism. Appl Psychophysiol Biofeedback 2002; 27: 163-181.
  • 82 Pietrobon D, Striessnig J. Neurobiology of migraine. Nat Rev Neurosci 2003; 4: 386-398.
  • 83 Rothrock JF, Parada VA, Sims C, Key K, Walters NS, Zweifler RM. The impact of intensive patient education on clinical outcome in a clinic-based migraine population. Headache 2006; 46: 726-731.
  • 84 Russell MB, Iselius L, Olesen J. Migraine without aura and migraine with aura are inherited disorders. Cephalalgia 1996; 16: 305-309.
  • 85 Seng EK, Holroyd KA. Dynamics of changes in self-efficacy and locus of control expectancies in the behavioral and drug treatment of severe migraine. Ann Behav Med 2010; 40: 235-247.
  • 86 Seng EK, Holroyd KA. Behavioral migraine management modifies behavioral and cognitive coping in people with migraine. Headache 2014; 54: 1470-1483.
  • 87 Silver BV, Blanchard EB, Williamson DA, Theobald DE, Brown DA. Temperature biofeedback and relaxation training in the treatment of migraine headaches. One-year follow-up. Biofeedback Self Regul 1979; 4: 359-366.
  • 88 Siniatchkin M, Hierundar A, Kropp P, Kuhnert R, Gerber WD, Stephani U. Self-regulation of slow cortical potentials in children with migraine: an explorative study. Appl Psychophysiol Biofeedback 2000; 25: 13-32.
  • 89 Spierings EL, Schroevers M, Honkoop PC, Sorbi M. Presentation of chronic daily headache: a clinical study. Headache 1998; 38: 191-196.
  • 90 Straube A. et al. Therapie und Versorgung bei chronischer Migräne. Expertenempfehlung der Deutschen Migräne- und Kopfschmerzgesellschaft/Deutsche Gesellschaft für Neurologie sowie der Österreichischen Kopfschmerzgesellschaft/Schweizerischen Kopfwehgesellschaft. Nervenarzt 2012; 83: 1600-1608.
  • 91 Stokes DA, Lappin MS. Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study. Behav Brain Funct 2010; 6: 9.
  • 92 Tracey I, Ploghaus A, Gati JS. et al. Imaging attentional modulation of pain in the periaqueductal gray in humans. J Neurosci 2002; 22: 2748-2752.
  • 93 Trautmann E, Kröner-Herwig B. A randomized controlled trial of Internet-based self-help training for recurrent headache in childhood and adolescence. Behav Res Ther 2010; 48: 28-37.
  • 94 US Headache Consortium. Practice parameter: evidence-based guidelines for migraine headaches (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology. Neurology 2000; 55: 754-762.
  • 95 Varkey E, Cider A, Carlsson J, Linde M. Exercise as migraine prophylaxis: A randomized study using relaxation and topiramate as controls. Cephalalgia 2011; 31: 1428-1438.
  • 96 Voerman JS, Klerk Cd, Mérelle SY, Aartsen E, Timman R, Sorbi MJ, Passchier J. Long-term follow-up of home-based behavioral management training provided by migraine patients. Cephalalgia 2014; 34: 357-364.
  • 97 Walker J. QEEG. Guided neurofeedback for recurrent migraine headaches. Clinical EEG and Neuroscience 2011; 42: 59-61.
  • 98 Wallasch TM, Kropp P. Multidisciplinary integrated headache care: A prospective 12-month follow-up observational study. J Headache Pain 2012; 13: 521-529.
  • 99 Wallasch TM, Angeli A, Kropp P. Outcomes of a headache-specific cross-sectional multidisciplinary treatment program. Headache 2012; 52: 1094-1105.
  • 100 Williamson DA, Monguillot JE, Jarrell MP, Cohen RA, Pratt JM, Blouin DC. Relaxation for the treatment of headache. Controlled evaluation of two group programs. Behav Modif 1984; 8: 407-424.
  • 101 Wolpe J. Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press; 1958