Is Volitional Manipulation of Hemodynamics a Valid Rationale for Biofeedback Therapy of Migraine?


  • M. Sovak M.D.,

    1. School of Medicine, University of California at San Diego, La Jolla, California.
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  • M. Kunzel M.A.,

  • R.A. Sternbach Ph.D.,

  • D.J. Dalessio M.D.



Responses of supraorbital (SA), superficial temporal (TA), and digital (F) arterial beds and the heart rate were studied in 5 normal subjects and 10 migraineurs, when their hand temperature was increased by volition and/or by heat. In normal subjects, volitional digital arterial dilation coincided with vasoconstriction in SA and TA. In migraineurs the response varied. Bradycardia resulted in most subjects except in unimproved migraineurs. Heat induced hand vasodilation led to dilation in SA and TA and to tachycardia. In those 8 migraineurs who improved clinically the finger temperature feedback training apparently did not result in conditioning of a single autonomic response (i.e. digital vasodilation), but in a general decrease of the sympathetic tonic outflow.