Multimodal migraine treatment: Does thermal feedback add to the outcome?

This study was carried out to examine the therapeutic necessity of thermal feedback training in a multimodal treatment program for migraine headache. Twenty-one patients with frequent (at least two per month) migraine headaches or combined migraine-tension headaches were randomly assigned to one of two conditions: (1) autogenic relaxation training followed by stress-coping training; (2) the same treatment package supplemented with thermal feedback. Results indicated the equivalent effectiveness of both treatments in ameliorating headache activity and reducing medication use. These outcomes were stable 7 months after treatment. Between group comparisons on clinical improvement and on temperature performance with autogenic relaxation, as well as findings - from post-treatment interviews, led to the conclusion that thermal feedback training can be excluded without weakening the program's therapeutic efficacy. In general the results suggest that thermal feedback per se does not add to the treatment outcomes obtainable with general relaxation training, and that for patients characterized by high achievement-motivation and sensitivity to initial failure a feedback regimen might even be counterproductive. Both findings need further experimental clarification.