# Online TEAM Migraine: Online Techniques and Education Aimed to Manage Migraine

> **NIH NIH R01** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2022 · $677,224

## Abstract

Summary
Migraine is the world's second leading cause of disability; half of the 45 million Americans with migraine require
bedrest for relief. Migraine affects overall health, relationships, careers, and financial stability. Disability is a
patient-centered outcome that captures the full impact of disease on patients' lives. Migraine medications are
limited by side effects, lack of efficacy, and costs. Despite recommendations against opioid use due to risks of
medication overuse headache and addiction, a third of Americans with migraine turn to opioids for acute relief.
There is an unmet need for more effective migraine therapies that target disability with long-term efficacy,
safety, and tolerability. Mindfulness-based stress reduction (MBSR) can help migraine as it targets stress, the
top migraine trigger. Mindfulness may change the pain experience through brain mechanisms associated with
nociceptive processing, cognitive function, and emotional regulation. We have shown mindfulness has
statistically significant and clinically meaningful benefits on disability, pain catastrophizing, depression, and
self-efficacy in patients with migraine. Interceptive awareness and headache frequency also improved. Our
prior research utilized designs with high methodological rigor (e.g., RCT) but were modest in size with
homogenous samples of participants able to engage with in-person classes that limited generalizability. Such
limitations may be offset by flexible online options. Patients with migraine are interested in electronic (e)Health
options, yet few evidenced-based options exist. This proposal addresses these gaps with a large study using
national recruitment and an online, accessible intervention that was developed to deliver key mindfulness
principles to diverse populations. We plan to test the efficacy of online MBSR vs. online HA education in adults
with migraine in a phase 3 RCT. The main goal will be evaluation of efficacy (Aim 1), with secondary goals of
understanding mechanisms (Aim 2) and gathering data (Aim 3) for a future, scalable implementation study. As
done previously, interventions will be matched on time/attention and participants will continue all current
migraine medications, as we have shown medication plus behavioral treatments have the greatest impact. This
fully remotely delivered study will determine the efficacy of online MBSR in adults with migraine to target the
urgent need for better migraine treatments on the patient-centered outcome of migraine disability. We are
using an eHealth delivery format that increases access and availability to diverse populations compared to in-
person weekly classes. Mind-body treatments can be leveraged to advance health equity and we will do so
through a variety of strategies. If effective, this research will lead to an implementation trial so that ultimately,
patients with migraine of diverse backgrounds will have an easily accessible, standardized, non-drug, non-
opioid treatment that could ...

## Key facts

- **NIH application ID:** 10442033
- **Project number:** 1R01AT011502-01A1
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Rebecca Erwin Wells
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $677,224
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10442033

## Citation

> US National Institutes of Health, RePORTER application 10442033, Online TEAM Migraine: Online Techniques and Education Aimed to Manage Migraine (1R01AT011502-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10442033. Licensed CC0.

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