Cerebri Biofeedback Feasibility Trial

A Prospective Feasibility Study of Daily, Home-based Biofeedback Therapy Using Cerebri for Migraine Treatment.

The purpose of this study is to investigate feasibility, usability, safety, efficacy, and tolerability of Cerebri biofeedback treatment for adults with episodic migraine.

In the study, the app-based biofeedback treatment Cerebri for migraines in adults will be tested. By using biofeedback, bodily signals that are thought to be associated with migraines, are measured. During the treatment, one sensor is attached on the shoulder to measure activity in the shoulder and neck muscles and one sensor is attached to the index finger to measure temperature and heart rate variability. By getting on-screen feedback on the phone, the user can learn techniques to reduce muscle tension, and increase finger temperature and heart rate variability. Reduced muscle tension, as well as increase in finger temperature and heart rate variability is a sign of relaxation and a deactivation of the nervous system, which can lead to fewer and less serious migraine attacks.

Inclusion Criteria:

• 18 years of age or older, at the time of signing the informed consent
• Episodic migraines with or without aura diagnosed by a neurologist/physician per International Classification of Headache Disorders 3rd edition (ICHD-3).
• Having kept a headache diary with at least 80% adherence as part of routine clinical care in the last 28-days prior to inclusion.
• History of at least 4 and up to 14 days of migraines per 28-day period in the 3 months prior to screening, as recalled by the subject and confirmed in the clinical diary.
• At least three months of experience with smartphone and access to an iOS or Android phone at home.
• Capable of giving signed informed consent as described in Appendix 1 which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
• Onset of migraine before age 50 years.

Exclusion Criteria:

• Having a continuous background headache that never disappears completely.
• More than 14 days of headache (all types) per 28-day period.
• Subjects diagnosed with trigeminal autonomic cephalalgias and neuralgias.
• Subjects with secondary headache conditions.
• Subjects with headaches attributed by the treating neurologist/physician as being medication overuse headache according to the ICHD-3.
• Subject with pathologies that inhibit use of the device according to the instructions for use (e.g., blindness, deafness).
• Use of any concurrent preventive treatment (medications, meditation, physical therapy and psychotherapy as a headache treatment, acupuncture, etc.).
• Subjects who have previously failed three prophylactic pharmacological treatments.
• Subjects taking opioids (>3 days per month) or barbiturates at the time of screening.
• Subject participates in another clinical investigation.
• Alcohol overuse according to ICD-10-CM Code F10.1 or illicit drug use.
• Subject who is unlikely to follow Clinical Investigation Plan or where treatment seems futile in the opinion of the Investigator or have demonstrated an inability to sufficiently adhere to headache diary entries (<80%).