Personality and psychophysiological self-regulation influence individual efficacy of neurofeedback in tension-type headache

INTRODUCTION: Due to limited efficacy and side effects of pharmacological therapy in tension-type headache (TTH), alternative approaches are feasible. Neurofeedback is a noninvasive neuromodulation technique increasingly used in practice, but, however, there is limited research on its efficacy. OBJECTIVES: To evaluate the efficacy of neurofeedback in TTH and to reveal the factors moderating treatment effects. METHODS: We analyzed the data from a pilot phase of an ongoing single case design cross-over sham-controlled study. Four females with TTH underwent 10 sessions of neurofeedback and 10 sessions of sham-neurofeedback in a randomized order. Participants filled a detailed headache diary 3 weeks before, during and 3 weeks after the treatment. At enrollment, we evaluated the personality factors with the MMPI, and performed a specially developed test on psychophysiological regulation of breath. RESULTS: Significant reduction of headache frequency and intensity was observed in 2 of 4 participants (responders). The responders were characterized by normal MMPI profile and, the same time, by lower baseline abilities for psychophysiological self-regulation. The non-responders had high MMPI profile (accentuation) and also higher abilities for psychophysiological self-regulation. CONCLUSIONS: On the base of preliminary data, we suggest that neurofeedback may be feasible in TTH patients with lowered abilities for in psychophysiological self-regulation. Accentuation of personality traits may interfere with the efficacy of neurofeedback.