News Articles, Neurology, Health Briefs
Cognitive behavior therapy eases pain in children with migraines
by Carla Kemp, Senior Editor
Ng QX, et al. Headache. Dec. 28, 2016, http://bit.ly/2iGNOm3.
Cognitive behavior therapy is effective for reducing pain in children with migraine headaches, according to a
meta-analysis of 14 randomized, controlled studies.
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Pharmacotherapy is the main treatment for migraine and includes nonsteroidal anti-inflammatory drugs, triptans
and dopamine antagonists as well as preventive agents. However, many of these drugs have not been studied
in children. They also can have side effects that preclude long-term use.
Behavior and lifestyle factors are thought to play a role in migraines. Therefore, nonpharmacological options,
such as cognitive behavior therapy (CBT), may be effective treatments. Studies in adults have shown CBT helps
manage migraines, but no meta-analysis of CBT use in children has been done.
The authors searched PubMed and Ovid databases for studies comparing CBT with placebo, wait-list control or
standard medication in patients younger than 20 years with a clinical diagnosis of migraine. Fourteen studies
were included in the analysis.
Pooled odds ratios of clinically significant improvement (defined as 50% or greater headache activity reduction)
after treatment and at follow-up of three months or later were OR 9.11 (95% CI: 5.01 to 16.58, P<.001) and OR
9.18 (95% CI: 5.69 to 14.81, P<.001), respectively.
The authors said CBT has several advantages over medications. It is noninvasive and has no known side
effects. However, therapy is time-consuming and can be costly. They noted that several studies included in the
analysis used CD-ROM or online programs to deliver therapy and were effective in managing migraines.
"There is good evidence that CBT is viable in the management of pediatric migraine, and it should thus be
routinely offered as a first-line treatment and not only as an add-on if medications prove ineffective," they
concluded.
Copyright © 2017 American Academy of Pediatrics