Digital and virtual interventions for migraine: A systematic review of randomized controlled trials
Abstract
Background Migraine is a heterogeneous disorder marked by recurrent attacks and highly variable treatment outcomes, and it continues to impose a substantial personal and societal burden worldwide, underscoring the need for innovative and accessible therapeutic approaches. Although pharmacological options have expanded in recent years, many patients still experience incomplete response or limited access to specialist care. In this context, digital and virtual technologies—including mobile health applications, remote electrical neuromodulation (REN), virtual reality (VR), biofeedback, and internet-based behavioral therapy—have emerged as promising non-pharmacological tools to enhance self-management and improve clinical outcomes. Methods We conducted a systematic review of randomized and quasi-randomized controlled trials (RCTs) evaluating digital or virtual interventions for migraine prevention or acute treatment. Searches were performed in MEDLINE and Embase (via PubMed and Ovid®) from database inception to September 4, 2025, following PRISMA guidelines (PROSPERO CRD420251078125). Eligible studies included adults with migraine diagnosed according to the International Classification of Headache Disorders (ICHD). Data were extracted on intervention type, outcomes, adherence, and adverse events. Risk of bias was assessed using the Cochrane RoB 2 tool. Results Twelve studies met inclusion criteria, mean age across studies ranged from 35 to 47 years and interventions included…
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