Relationship between biofeedback and oxidative stress in patients with chronic migraine

Chronic migraine (1.5.1) is burdened with headache-related disability. During noxious stimulation changes of cerebral blood flow enhance the release of oxygen free radicals that react with nitric oxide (NO). We investigated the role of biofeedback in limiting migraine disability by influencing the oxidative stress. Peroxides, NO, and superoxide dismutase (SOD) were analyzed in 20 female subjects with chronic migraine and in 20 female healthy controls before and after biofeedback sessions. NOx levels (23.7±4.2 vs 34.9±4.6 µM; P<0.05) and SOD activity (6.5±1.0 vs 8.0±0.7 U/ml; P<0.05) were lower in migraine sufferers before treatment than in healthy controls, while peroxides levels (145.8±40.3 vs 78.0±20.0 µM; P<0.05) were higher in migraine sufferers before treatment than in healthy controls. In migraine sufferers NOx levels (23.7±4.2 vs 31.3±7.1 µM; P<0.05) and SOD activity (6.5±1.0 vs 7.9±0.9 U/ml; P<0.05) were lower before than after treatment while peroxides levels (145.8±40.3 vs 82.4±21.1 µM; P<0.05) were higher before than after treatment. SOD serum activity correlated positively with NOx serum levels and negatively with peroxides serum levels in healthy controls and in chronic migraine sufferers before and after biofeedback. The mean MIDAS score before biofeedback sessions was higher than after treatment (36.9±13.9 vs 18.8±10.4; P<0.001). The effectiveness of biofeedback in limiting chronic migraine may be related to muscular relaxation associated to decreased oxidative stress accompanied by a psychological wellbeing.