Biofeedback-Assisted Autogenic Training for Chronic Tension-Type Headache in a Korean Population / 신경정신의학

OBJECTIVES: We aimed to evaluate the efficacy of biofeedback-assisted autogenic training for chronic tension-type headache, and to determine the relationship among the changes in electromyography (EMG) activity, headache activity, and mood states according to the psychophysiological treatment. METHODS: Chronic tension-type headache patients aged from 20 to 40 years (n=35) were randomized to the treatment group receiving biofeedback-assisted autogenic training (8 sessions) or the monitoring-only control group. EMG activities, headache index, and various psychological variables were examined. RESULTS: We found greater treatment response rate (> or =50% reduction in headache index) in patients with biofeedbackassisted autogenic training than in the monitoring group (61% vs. 18%; chi-square=6.882, df=1, p=0.01). There were no significant changes in the mean values of the pretreatment EMG activities across the sessions in either group (all p's>0.1). Mood states including anxiety and depression improved over time in the both groups, with the improvements being more prominent in the treatment group. Moreover, the reduction in depression level predicted treatment outcome in terms of headache index (95% confidence interval: 0.272-0.966, p=0.039). CONCLUSION: These results show that biofeedback-assisted autogenic training is effective for the treatment of chronic tension-type headache in a Korean population. Changes in mood states may be closely associated with the clinical outcome in the treatment of chronic tension-type headache using biofeedback-assisted autogenic training.

Effect of Pharmacotherapy with Paroxetine on Biofeedback Measurement Variables in Panic Disorder Patients / 대한정신약물학회지

OBJECTIVE: There have been much effort to find reliable indicators predicting treatment response in panic disorder. This study aimed to find the effect of pharmacotherapy on biofeedback measurement variables in panic disorder patients. METHOD: We recruited 38 panic disorder patients (M:25, F:13) in the Samsung Medical Center, who were diagnosed by the ADIS-IV (Anxiety Disorder Interview Schedule-IV), and 33 normal control subjects (M:21 F:12). Panic patients were treated with paroxetine for 3 months. All subjects were assessed on forearm and frontal electromyography (EMG), electrodermal response (EDR), and skin temperature in baseline, stress, recovery phases using the Procomp & Biograph biofeedback instrument. Psychological measures such as Hamilton anxiety rating scale (HAM-A), Hamilton depression rating scale (HAM-D), Beck depression inventory (BDI), Spielberger state-trait anxiety inventory (STAI-S, STAI-T), and Anxiety sensitivity index (ASI) were also assessed. All measurements were performed at the beginning of the study and after 3 months of paroxetine treatment. RESULT: Panic patients had significantly higher scores on psychological measures such as HAM-A, HAM-D, BDI, STAI-S, STAI-T, and ASI (all p values<0.001) before treatment. After 3months of treatment, panic patients showed significant improvement on baseline EDR (z=-2.824, p=0.005), stress EDR (z=-2.691, p=0.007), and recovery EDR (z=-3.416, p=0.001). They also showed significant improvement on HAM-A, HAM-D, BDI, STAI-S, STAI-T, and ASI (all p values<0.001) after treatment. CONCLUSION: Electrodermal response, one of the biofeedback measurement variables, was suggested to be the possible indicator predicting treatment response in panic disorder.