PO-65 | The complexity of chronic headache: towards tailored therapies through a multidimensional assessment

Silvia Favaretto,¹ Giulia Demo,² Veronica Rizzato,² Elisabetta Patron,^2,3,4 Sara Bianconi,² Stèphanie Maldera,² Giulia Buodo,^2,3 | ¹UOC Clinica Neurologica, Azienda Ospedale-Università Padova, Padua, Italy; ²Centro di Ateneo Servizi Clinici Universitari Psicologici (SCUP), University of Padua, Italy; ³Department of General Psychology, University of Padua, Padova, Italy; ⁴Padua Neuroscience Center (PNC), University of Padua, Padova, Italy

Background: Despite the effectiveness of the multidisciplinary approach in treating chronic headache, there is no consensus on the diagnostic and therapeutic protocols. This preliminary study, conducted in collaboration between the Neurological Clinic of the Padua Hospital-University and the Biofeedback and Psychophysiology Unit of the SCUP Center, explores the relationships between physiological, cognitive, and affective factors in the assessment and treatment of patients with chronic headache.

Methods: Seventeen headache patients underwent multidisciplinary assessments, including neurological visits, psychological interviews, and psychophysiological evaluations. Eleven patients started a multidisciplinary treatment: 5 started pharmacological therapy and biofeedback (BF), 6 started pharmacological therapy, BF, and cognitive-behavioral therapy.

Results: Significant correlations emerged between pain severity, the tendency to catastrophize pain-related thoughts (R=0.620; p=0.008), and somatic symptoms (R=0.532; p=0.034). Moreover, catastrophizing negatively correlated with muscle tension during a stress test (R=-0.591; p=0.016). Patients with higher resting muscle tension were assigned to pharmacological therapy and BF (t=1.980; p=0.040). 

Conclusion: These results support the importance of a multidisciplinary approach in the management of chronic headache, highlighting the interaction between physiological and cognitive factors. Patients with high muscle tension might benefit more from the integration of pharmacotherapy and biofeedback, while those with high catastrophizing might benefit from cognitive interventions. These preliminary data underscore the value of a comprehensive multidisciplinary assessment, which proves fundamental for developing personalized therapeutic interventions. This approach, in line with the principles of precision medicine, could optimize treatment effectiveness by adapting to the specific psychophysiological characteristics of each patient with chronic headache.