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Given that it was a young person, but also loads with her law study, the idea was to strengthen the relaxed focus with neurofeedback and reduce internal tension. Along with the effectiveness of neurofeedback that we have been able to see in improving performance as well as at some difficulties during our decades of use, we thought that it is a good choice to work with a migraine.
Subsequently, we have been using vasoconstriction-vasodilation training with the aim of enabling a person to learn that vasoconstriction occurs when a migraine occurs. The training is done in such a way that the sensor is set to a. During the min training sessions, we had 4-min vasoconstriction training and 1-min relaxation training alternate. Choosing all three training sessions at the same time was to prompt positive changes in pain reduction as well as migraine rates. The reason for choosing that particular way of training neurofeedback, breathing, vasoconstriction training was to have one relaxation training between two difficult pieces of training.
It is not so easy to work one hour and a half with maximum work of the person. We also could recommend monitoring peripheral temperature as a secondary parameter during vasoconstriction training, but we did not consider it necessary to include it because the effectiveness of the training achieves vasodilation, that is, a certain blood flow, which also increases the peripheral temperature.
Of course, it would be useful to put the sensor in peripheral temperature for future research. We did not use EMG biofeedback, it was not necessary in this particular case.
HEG would certainly be useful as a method and probably use it to have it in the software. During the training session, there was no migraine, or a headache was on pain scale 3, on the scale of 1— Electrode position was according to the international 10—20 systems, and frequency bands were inhibited or rewarded. Administered protocols were on Cz, C4, and C3. Neurofeedback was used to increase sensory motor rhythm SMR in the sensory-motor area, to decrease high beta activities and to learn to maintain a relaxed state with a clear focus and concentration.
Below is a description of the neurofeedback training with a detailed performance about working on individual points according to the international 10—20 systems:. Implementation of biofeedback included vascular training which means 25 sessions of vascular training on a. We used the device that had the vascular training. The goal was to have the amplitude of BVP signal smaller at training phase than relax phase. The results of the few training we shown in Figures 1 , 2 , 3. Breathing is a willing and reluctant function, which means we can, but we do not have to pay attention to breathing.
Breathing is under control of the breathing center located in the extended spinal cord, which means that the breathing takes place without our influence. It is controlled by an autonomic nervous system that manages various functions in the body and is often not recognized or affected by them. How then to affect the function of breathing? Breathing can be controlled by a conscious mechanism of breathing an attempt to relax the body and slow down the physiological processes. Today, when the challenges—and therefore stressors—in everyday life are very intense, body relaxation for the sake of health is very important.
People who use certain breathing techniques feel their benefit. They are more relaxed, they feel happier, and they do not feel in their own body of great pressures of everyday life. To explain why breathing is important and how it affects a person, we need to look at the vascular system that is also affected by the autonomic nervous system.
The most frequent changes due to the great pressures in life most people feel in that system. Common respiratory changes are associated with retardation or acceleration of the bloodstream and are caused by the sympathetic and parasympathetic autonomic nervous system. The first accelerates it, and the other serves to slow down all the functions in the body.
The same happens with breathing—in the sympathetic work of the autonomic nervous system, the breathing is faster, shallow, and irregular, while in the parasympathetic effect, breathing is slower, which most commonly occur during rest and sleep without our influence. For the body to function normally, it is necessary to balance both systems. Experts engaged in the vascular system of research have found that reducing cardiac variability leads to a greater inclination to the bloodstream disease, and deaths are also more common. Also, biofeedback use aims to increase heart rate variability by using breathing techniques.
So, breathing is a tool that we use not only to relax but to influence the well-being of the bloodstream system. The breathing used in the training itself is breathing with the diaphragm breathing with belly that breathes the lowest part of the respiratory system—the diaphragm—as we show in Figure 4. The person had instructions to use this breathing also at home at least once a day taking care that the breathing is taking place without the influence of external distractors. Breathing technique is a recommended method for relaxation and to reduce stress which is important for people with a migraine.
Breathing with the diaphragm is the healthiest breathing we can use. The aim is to provide the best possible exchange of oxygen and carbon dioxide. The body of the belly breathing curves upward, so that the lower part of the chest is enlarged and the lower part of the lung fills with air, as the belly breathes. With this breathing, we get a full effect: the fullness of the ribs, the bones, the spine, and the scurvy and thus the higher lung capacity.
In people who are often affected by different stressors, the use of breathing techniques is of utmost importance. Breathing encourages the parasympathetic action of the autonomic nervous system that slows down and relaxes our body. Breathing is a mechanism that affects HRV and changes that will lead to optimum functioning of the individual. Below is a detailed description of breathing by using the diaphragm. Take a comfortable position and remove anything that sticks around you.
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If you are feeling comfortable, place your palms on the belly, at the height of the navel. Slowly breathe through your nose counting in yourself by three, inflating your belly as if you were blowing a balloon Figure 5. When you are breathing out, open your mouth slightly, and slowly exhale by counting to six until you breathe all the air Figure 6.
Only the body will stimulate your next breath and repeat the cycle. Exercise at least once a day.
Headache-related health resource utilisation in chronic and episodic migraine across six countries
You can use it several times if you feel the need for relaxation. According to the treatment of the person with a migraine, we have done a total of 25 treatments. Three modalities were used at each treatment: neurofeedback, vascular training, and breathing techniques. The training sessions were done 2—3 times per week. The results were a reduction in the frequency of migraine attacks, as well as a reduction in pain severity during the attacks.
The reduction in the frequency of migraine attacks and in the strength of pain was gradual. In September, the person had nine migraines, with pain ranges between 8 and 9. In October, the person had six migraine attacks 3 less , pain strengths from 5 to 8. In November there were five migraine attacks, with a pain score from 2 to 7. The person learned to apply the vasoconstriction method when she was experiencing migraine, which reduced the strength of the pain. Also, breathing technique became normal training used daily.
The efficacy of biofeedback is evident in the application of the method, for the reduction of a migraine as well as pain relief. Our experience has shown that it is important to take a good initial assessment and know all relevant information of a migraine as well as to the person itself and to agree with the person on possible treatment goals as well as the incidence of arrivals.
The emphasis is on the motivation of the person as well as encouraging motivation, which is always it happens as the frequency and strength of headaches are reduced. Our case study has shown the good curative potential of biofeedback and neurofeedback treatments at a migraine.
We confirmed earlier research results that different types of biofeedback methods could have some benefits to people with migraine. Also, we gave some our way of training. Combination of treatments neurofeedback, breathing, and vascular training in 25 sessions helped the female patient with a long history of a severe migraine. Further research of patients suffering from migraine with different treatment protocols is needed to establish the method. Therefore, a comprehensive approach to solving this problem is very important, and education, to both the general population and the patients, and the raising of health care to a higher level, with ongoing support for patients suffering from a migraine, are indispensable for the formation of a healthier society.
Combination of pharmacologic and behavioral treatments such as relaxation training and cognitive behavior therapy can lead to faster and better results with people who suffer from migraine [ 43 , 44 ]. Empirically validated behavioral treatments include biofeedback training; relaxation training, combinations of the two, stress management training, and cognitive behavioral therapy could be helpful for people with migraine headache.
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