Migraine is the second leading cause of disability, yet patients frequently discontinue medication because of inefficacy or adverse effects. Mindfulness-based stress reduction is associated with improvements in reducing affective responses to stress, the most common migraine trigger. A randomized clinical trial was designed to determine whether mindfulness-based stress reduction improves migraine outcomes and affective and cognitive processes, compared with headache education.

To be eligible for the study, patients had to have been diagnosed with migraine, have at least a one-year history of migraine, experience four to 20 migraine days per month, be at least 18 years old, and be available for eight weekly classes. Participants were randomized to receive mindfulness-based stress reduction or headache education. They were asked to maintain stable migraine medications for the duration of the study. Both groups' education interventions were comparable in duration, format, and number of participants. Participants in the mindfulness-based stress reduction intervention were also instructed to practice at home for 30 minutes a day.

A total of 89 participants (92% were women; mean age, 43.9 years) completed the study. Participants had a mean 7.3 migraine days per month and high headache-related disability.

At 12 weeks, both groups had fewer migraine days per month, with no statistical differences between them. Compared with the headache education group, participants in the mindfulness-based stress reduction group had significant improvements from baseline to 12, 24, and 36 weeks in headache-related disability, quality of life, self-efficacy, pain catastrophizing, and depression scores. Those trained in mindfulness also had a greater decrease in perception of experimental pain intensity and unpleasantness.