Efficacy of mindfulness-based interventions and biofeedback for migraine management: a systematic review and meta-analysis of randomized controlled trials
Abstract
ObjectiveThis systematic review and meta-analysis of randomized controlled trials aims to analyze the efficacy of mindfulness-based interventions and biofeedback on headache frequency, pain intensity, headache-related disability, psychological distress, and quality of life in adult patients with migraine.MethodsThe review followed the PRISMA statement and was registered in PROSPERO (CRD420261381587). A structured search was conducted across PubMed, Scopus, and PsycInfo for RCTs published in English between May 2016 and May 2026. Seven clinical trials (n = 535 participants) met the inclusion criteria. Methodological quality and risk of bias were evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool.ResultsThe pooled analysis for headache frequency (n = 6 studies) showed no statistically significant differences between groups (MD = −0.59; 95% CI: −1.81 to 0.62; p = 0.34). Conversely, significant improvements favoring the experimental groups were found for headache-related disability measured with the HIT-6 scale (n = 6 studies; MD = −2.28; 95% CI: −4.47 to −0.08; p = 0.04), pain intensity (n = 3 studies; SMD = −0.39; 95% CI: −0.64 to −0.14; p = 0.002), and health-related quality of life (n = 3 studies; MD = +5.21; 95% CI: 1.95 to 8.47; p = 0.002). No statistically significant differences were observed for anxiety (p = 0.30) or depression (p = 0.88).ConclusionInterventions incorporating Mindfulness-Based Interventions and Biofeedback do not significantly reduce objective migraine attack frequency compared to control conditions, nor do they yield distinct differences in affective outcomes (anxiety/depression)—which may partly reflect subclinical baseline depression scores in episodic cohorts, active-comparator effects, and instrument heterogeneity. However, they exhibit statistically significant efficacy in decreasing subjective pain intensity, mitigating headache-related functional disability, and restoring health-related quality of life, supporting their role as valuable complementary strategies for self-regulation and clinical coping in migraine management.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261381587, Identifier: CRD420261381587.
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BibTeX
@article{zahrihaidar2026efficacy,
title = {{Efficacy of mindfulness-based interventions and biofeedback for migraine management: a systematic review and meta-analysis of randomized controlled trials}},
author = {Chaimae Zahri-Haidar and Jose I. Recio-Rodriguez and Natalia Sanchez-Aguadero and Hsin-Chien Lee and Luis López-Mesonero and Hsueh-Chen Lu and Irene A. Garcia-Yu},
journal = {Frontiers in Neuroscience},
year = {2026},
month = nov,
doi = {10.3389/fnins.2026.1965907},
url = {https://www.frontiersin.org/articles/10.3389/fnins.2026.1965907},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Efficacy of mindfulness-based interventions and biofeedback for migraine management: a systematic review and meta-analysis of randomized controlled trials
AU - Chaimae Zahri-Haidar
AU - Jose I. Recio-Rodriguez
AU - Natalia Sanchez-Aguadero
AU - Hsin-Chien Lee
AU - Luis López-Mesonero
AU - Hsueh-Chen Lu
AU - Irene A. Garcia-Yu
PY - 2026
DA - 2026/11/11
JO - Frontiers in Neuroscience
DO - 10.3389/fnins.2026.1965907
UR - https://www.frontiersin.org/articles/10.3389/fnins.2026.1965907
AB - ObjectiveThis systematic review and meta-analysis of randomized controlled trials aims to analyze the efficacy of mindfulness-based interventions and biofeedback on headache frequency, pain intensity, headache-related disability, psychological distress, and quality of life in adult patients with migraine.MethodsThe review followed the PRISMA statement and was registered in PROSPERO (CRD420261381587). A structured search was conducted across PubMed, Scopus, and PsycInfo for RCTs published in English between May 2016 and May 2026. Seven clinical trials (n = 535 participants) met the inclusion criteria. Methodological quality and risk of bias were evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool.ResultsThe pooled analysis for headache frequency (n = 6 studies) showed no statistically significant differences between groups (MD = −0.59; 95% CI: −1.81 to 0.62; p = 0.34). Conversely, significant improvements favoring the experimental groups were found for headache-related disability measured with the HIT-6 scale (n = 6 studies; MD = −2.28; 95% CI: −4.47 to −0.08; p = 0.04), pain intensity (n = 3 studies; SMD = −0.39; 95% CI: −0.64 to −0.14; p = 0.002), and health-related quality of life (n = 3 studies; MD = +5.21; 95% CI: 1.95 to 8.47; p = 0.002). No statistically significant differences were observed for anxiety (p = 0.30) or depression (p = 0.88).ConclusionInterventions incorporating Mindfulness-Based Interventions and Biofeedback do not significantly reduce objective migraine attack frequency compared to control conditions, nor do they yield distinct differences in affective outcomes (anxiety/depression)—which may partly reflect subclinical baseline depression scores in episodic cohorts, active-comparator effects, and instrument heterogeneity. However, they exhibit statistically significant efficacy in decreasing subjective pain intensity, mitigating headache-related functional disability, and restoring health-related quality of life, supporting their role as valuable complementary strategies for self-regulation and clinical coping in migraine management.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261381587, Identifier: CRD420261381587.
SN - 1662-453X
SN - 1662-4548
ER -