NYU Langone Health Headache Center Learning Migraine Self-Management Techniques Study

Prior treatment

• Diagnosis of Medication Overuse Headache (MOH)
• Patients who have had Cognitive Behavioral Therapy, Biofeedback, or other Relaxation Therapy for migraine in the past year
• Alcohol or other substance abuse as determined by self-report or prior documentation in the medical record
• PHQ-8 scores greater than 15, indicating a conservative score of moderately severe depressive symptoms based on the PHQ-9 (in this group, more intense psychological intervention targeted to the depression may be needed, as depression is a significant predictor of migraine chronification and people with migraine and comorbid depression are more likely to be refractory to migraine treatments and to develop medication overuse headache)

Other illness

• Coronary heart disease, heart attack, stroke, diabetes mellitus Type 1 or II

Other

• Current opioid or barbiturate use
• Unable or unwilling to follow a treatment program that relies on written and audio-taped materials
• Pregnant (because hormonal fluctuations in pregnancy can affect migraine outcomes)
• Other physical limitations which would prevent participating in the standard protocol of biofeedback being studied

• English speaking. (At this time, the validated app is only available in English.)
• 18-65 years of age
• Meets International Classification of Headache Disorder (ICHD)-3 migraine criteria based on a headache specialist or neurologist
• Headaches for ≥1 year
• Has not begun a new migraine preventative medication in the last month
• Agreement to not make any preventive medication changes from the time of trial start until 3 months after beginning the study (Note - Acute medications may be changed if needed. Changes in preventive and acute medication and the time initiated will be recorded to evaluate the potential for medication confounds)
• 4-29 headache days a month (so the study includes those in whom the investigators typically offer preventive treatment \[\>4 headache days/month\] and those with more frequent migraines including chronic migraine \[15 days or more/month\] but exclude those with continuous headaches)