Mindfulness and Mechanisms of Pain Processing in Adults With Migraines

Migraine is a common and disabling pain condition. Affective/cognitive processes, such as
pain catastrophizing and emotional reactivity, often play a major role in migraine pain and
disability. These processes may be just as important to target as the sensory aspect given
their impact on outcomes and disability. Because of this cognitive/affective load that builds
over time in migraine, we hypothesize A) migraineurs perceive affective pain processing
differently than non-migraineurs and B) mind/body therapies that target these factors may be
especially beneficial and may differentially impact the affective component of migraine pain.
Evidence shows that meditation decreases affective (e.g., pain unpleasantness) over sensory
(e.g., pain intensity) response to experimental pain and reduces pain by engaging brain
regions important for cognitive and affective modulation of pain. By measuring both
experimental and clinical pain, the study team will be able to test these hypotheses.

Inclusion Criteria:

Diagnosis of migraine; ≥18yo; ≥1 yr of migraines; 4-20 days/month with migraines; able and
willing to participate in 8 weekly sessions and daily homework 30-45min

Exclusion Criteria:

Current regular (weekly or more often) practice of meditation; any major unstable
medical/psychiatric illness (e.g., hospitalization within 90 days, suicide risk, etc.);
other non-migraine chronic pain condition (e.g., fibromyalgia, low back pain, etc.) or
sensory abnormalities (e.g., neuropathy, Raynaud's, etc.); diagnosis of medication overuse
headache; volunteers with no pain ratings to frankly noxious stimuli (temperatures > 49°C)
or excessive responses to threshold temperatures (~43°C); current or planned pregnancy or
breastfeeding, any new medication started within 4 weeks of screening visit; unwilling to
maintain stable current medication dosages for duration of trial; failure to complete
baseline headache logs.