Trial reportThe journal of headache and pain2016
Biofeedback in the prophylactic treatment of medication overuse headache: a pilot randomized controlled trial.
Trial report in The journal of headache and pain, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Effect of Educational and Behavioral Interventions on Medication-Overuse Headache: A Systematic Review and Meta-Analysis.Pain research & management · 2026Pooled it
- Behavioral interventions for migraine prevention: A systematic review and meta-analysis.Headache · 2025Pooled it
- From research to clinical practice: a systematic review of the implementation of psychological interventions for chronic headache in adults.BMC health services research · 2020Pooled it
- Mindfulness Meditation for Primary Headache Pain: A Meta-Analysis.Chinese medical journal · 2018Pooled it
- Effects of transcranial direct current stimulation on pre-competitive cognitive performance and anxiety in collegiate athletes: a randomized controlled trial.Scientific reports · 2025Trial
- Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.The journal of headache and pain · 2017Trial
- Breaking the medication overuse headache cycle: from nociplastic pain mechanisms to patient-centered interventions - the Junior Editorial Board vision.The journal of headache and pain · 2026Review
- The impact of biofeedback in enhancing chronic pain rehabilitation: A systematic review of mechanisms and outcomes.Heliyon · 2025Review
- Behavioral therapy in migraine: Expanding the therapeutic arsenal.European journal of neurology · 2024Review
- Non-Pharmacological Treatments in Paediatric Migraine.Journal of clinical medicine · 2024Review
- Management of medication overuse (MO) and medication overuse headache (MOH) S1 guideline.Neurological research and practice · 2022Article
- Migraine management: Non-pharmacological points for patients and health care professionals.Open medicine (Warsaw, Poland) · 2022Review
- The Use of Behavioral Modalities for Headache During Pregnancy and Breastfeeding.Current pain and headache reports · 2021Review
- The Ruminative Thought Style with Associated Anxiety Influences the Occurrence of Medication-Overuse Headache.Journal of clinical neurology (Seoul, Korea) · 2021Article
- Nutraceuticals and Behavioral Therapy for Headache.Current neurology and neuroscience reports · 2021Review
- Non-Pharmacological Approaches to Headaches: Non-Invasive Neuromodulation, Nutraceuticals, and Behavioral Approaches.International journal of environmental research and public health · 2021Review
- Non-Pharmacological Approaches for Migraine.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2018Review
- A Critical Evaluation on MOH Current Treatments.Current treatment options in neurology · 2017Review
- Treatment Update of Chronic Migraine.Current pain and headache reports · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedication overuse headache (MOH) is a major clinical concern and a common health risk. Recent literature stressed the need to manage chronic headache by using integrated biobehavioral approaches. Few studies evaluated how biofeedback can be useful in MOH. The aim of the study is to evaluate in a randomized, controlled, single-blind trial the effects of biofeedback associated with traditional pharmacological therapy in the prophylactic treatment of MOH.
methodTwenty-seven subjects were randomized to frontal electromyographic (EMG) biofeedback associated with prophylactic pharmacological therapy (Bfb Group) or to pharmacological treatment alone (Control Group). The primary outcome was to evaluate the number of patients that return episodic after treatment. Secondly we evaluate the effects of frontal EMG BFB on frequency of headache and analgesic intake. Changes in coping strategies and in EMG frontalis tension were also evaluated. ANOVA was performed on all the variables of interest.
resultsOur results indicate that at the end of treatment the number of patients that returned episodic in the Bfb group was significantly higher than in the Control group. Patients in the Bfb group differed from the Control group in headache frequency, amount of drug intake and active coping with pain. These outcomes were confirmed also after 4 months of follow-up. No significant effects were observed in EMG recordings.
conclusionsBiofeedback added to traditional pharmacological therapy in the treatment of MOH is a promising approach for reducing headache frequency and analgesic intake. Modification of coping cognitions in the Bfb group, as an adjunct mechanism of self-regulation, needs more evaluations to understand the role of biofeedback in changing maladaptive psychophysiological responses.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.