Dr. Frank Andrasik (photo) at the University of West Florida, in Pensacola has reviewed the evidence for each category of biofeedback.

Here’s what we know about preventive or acute therapy for migraine.

Grade A evidence

  • Relaxation training
  • Thermal biofeedback combined with relaxation training
  • Electromyographic biofeedback
  • Cognitive-behavioral therapy

Grade B evidence

  • Behavioral therapy (ie, biofeedback, relaxation) may be combined with preventive drug therapy to achieve additional migraine relief

Insufficient evidence

  • Hypnosis
  • Acupuncture
  • Transcutaneous electrical nerve stimulation
  • Cervical manipulation
  • Occlusal adjustments (intentional mechanical grinding of selected biting surfaces of teeth to improve the contact)
  • Hyperbaric oxygen as preventive or acute therapy for migraine

The bottom line?

Grade A evidence means there are multiple well-designed studies revealing a consistent pattern of positive findings

Grade B evidence means there is some, but not optimal supporting evidence from well-designed studies. This is often because there were too few studies or inconsistent findings.

11/19/10 20:42 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.