Pain Reprocessing Therapy for migraine: A case series
Abstract
Pain Reprocessing Therapy (PRT) is a behavioral intervention that aims to remediate learned threat associations underlying chronic pain. It has shown efficacy in treating chronic low back pain and was explicitly developed to address a broader range of centrally mediated pain conditions. The focus of PRT on learned threat associations dovetails with emerging neurobiological models of migraine, which highlight learned threat associations-nonharmful internal (e.g., hunger, fatigue) or external (e.g., weather changes) cues that are persistently misinterpreted as danger signals-as a modifiable contributor to migraine pathophysiology. Despite its conceptual relevance, PRT has not yet been studied for migraine, a leading cause of disability with an ongoing need for more effective treatments, especially for patients who are refractory to evidence-based treatments. Addressing this gap, we present the first case series on PRT for migraine. We describe three individuals with chronic migraine who engaged in PRT delivered by a physician. All three patients had inadequate response to standard-of-care preventive and acute migraine treatments and presented with complex clinical histories, including non-headache pain comorbidities. PRT sessions (initial visit 60 min; follow-ups 30 min) focused on two key components: (1) education about neuroplastic pain and its relevance to migraine, and (2) guided instruction and daily practice of somatic tracking. Across all three cases, patients…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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