Effects of Frontalis EMG Biofeedback and Diazepam in the Treatment of Tension Headache

SYNOPSIS
Frontalis EMG biofeedback and diazepam treatments were compared in tension headache patients; headache scores (intensity and frequency) and frontalis EMG were used as control parameters. The study, conducted in a double blind manner, was split in three equal observation periods (4 weeks): baseline, treatment and follow-up. Four patient groups were chosen, two of which received placebo treatment. In both true conditions, biofeedback and diazepam, treatment effects differentiated from placebo groups; with diazepam the strongest results upon headache and frontalis EMG were observed during treatment, which, however, were lost at the follow-up period; biofeedback although with weaker effects during treatment showed, at follow-up, a long lasting reduction of headache scores even when frontalis activity reached baseline levels; in the false biofeedback group some decrease of EMG activity during treatment and of headache intensity at follow-up were also observed. The data suggest that biofeedback is a complex learning situation, where several uncompletely known factors are possibly at work; it also raises the possibility of a complex relation between frontalis muscular activity and headache since a simple linear relation of both variables was not observed.