Key result
Behavioral weight loss matches migraine education in reducing pain catastrophizing and allodynia.
Why the study?
It was unclear whether pain catastrophizing and cutaneous allodynia are modifiable and whether nonpharmacological treatment-related changes in them relate to migraine improvements.
Does behavioral weight loss compared to migraine education improve pain catastrophizing and allodynia in women with migraine and overweight/obesity?
RCT (n=110)
randomly assigned
Does behavioral weight loss compared to migraine education improve pain catastrophizing and allodynia in women with migraine and overweight/obesity?
Nonpharmacologic treatments for migraine reduce pain catastrophizing and allodynia, which is associated with reduced headache-related disability independent of migraine severity.
Answers are grounded in this paper and cite their sources.
Reductions in pain catastrophizing and allodynia after nonpharmacologic migraine treatment associate with lower disability independent of severity; extends evidence for these as modifiable targets.
OBJECTIVE: Pain catastrophizing and cutaneous allodynia represent two risk factors for greater headache-related disability. Yet, there is limited knowledge of the extent to which these risk factors are modifiable and whether nonpharmacological treatment-related changes are associated with migraine improvements. Using data from the Women's Health and Migraine (WHAM) study, a randomized controlled trial that compared effects of behavioral weight loss (BWL) and migraine education (ME) in women with migraine and overweight/obesity, we tested whether: (a) BWL versus ME produced greater changes in pain catastrophizing and allodynia from baseline across posttreatment and follow-up time points, and (b) whether these improvements were associated with improvements in headache disability. METHOD: = 110) were randomly assigned to 16 weeks of either BWL or ME and assessed at baseline, posttreatment, and follow up (32 weeks). Multilevel mixed effects modeling tested: (a) for between-groups differences in pain catastrophizing and allodynia changes over time, and (b) associations of changes in pain catastrophizing and allodynia with changes in headache disability, adjusting for migraine severity and weight loss. RESULTS: Both BWL and ME had significant reductions in pain catastrophizing and allodynia from baseline to posttreatment and follow up, and the improvements were comparable across conditions. Reductions in pain catastrophizing and cutaneous allodynia were associated with significant reductions in headache disability, even when controlling for intervention-related improvements in migraine and weight loss. CONCLUSION: Pain catastrophizing and allodynia are not only reduced after nonpharmacologic treatments for migraine, but greater improvements are associated with greater reductions in headache-related disability, independent of migraine severity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Farris et al. (2020) conducted an RCT in Migraine and overweight/obesity (n=110). Behavioral weight loss vs. Migraine education was evaluated on Changes in pain catastrophizing and allodynia. Behavioral weight loss and migraine education produced comparable reductions in pain catastrophizing and allodynia at 32 weeks, which were associated with reduced headache disability.
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