***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The objective of this study was to evaluate the effectiveness of a Self-Administered Behavioral Intervention using Tailored messages ( SEABIT ) for migraine . The primary measures were headache days , headache-related disability , behavioral/emotional factors , and headache-related beliefs . BACKGROUND Behavioral and cognitive-behavioral interventions for migraine treatment are well established and possess " Grade -A " evidence based on the U.S. Headache Consortium evidence -based guidelines . To increase the accessibility of behavioral interventions in primary and other setting s , treatment can be delivered in self-administered formats . Incorporating tailored health communication strategies ( via tailored messages ) into a self-administered format can help maintain a level of personalization without requiring regular visits to a behavioral specialist . Tailored messages are created using individual-level assessment data to educate and motivate the patient to develop behavioral skills and strategies for migraine prevention and management . METHODS Twenty-five individuals ( 95 % female , 90 % Caucasian , mean headache years = 21.0 ) began and 84 % ( 21/25 ) completed all phases of the 8-week SEABIT developed for  migraine prevention  ( preceded by a 1-month baseline phase and followed by a 1-month postintervention phase ) . RESULTS Overall , 62 % ( 13/21 ) reported at least a 50 % reduction in headache frequency , and mean headache frequency for the group was also significantly reduced from baseline to postintervention ( 16.9 vs. 10.7 , P < .001 ; eta2= .61 ) . Headache-related disability , behavioral/emotional factors , and headache-management self-efficacy also showed significant improvement . CONCLUSION The findings suggest that the SEABIT for migraine prevention is an effective behavioral intervention that potentially could be accessed and distributed in a variety of setting s including primary care Background : Chronic migraine ( CM ) is a debilitating neurological disorder with few treatment options . Peripheral nerve stimulation ( PNS ) of the occipital nerves is a potentially promising therapy for CM patients . Methods : In this r and omized , controlled multicenter study , patients diagnosed with CM were implanted with a neurostimulation device near the occipital nerves and r and omized 2:1 to active ( n = 105 ) or sham ( n = 52 ) stimulation . The primary endpoint was a difference in the percentage of responders ( defined as patients that achieved a ≥50 % reduction in mean daily visual analog scale scores ) in each group at 12 weeks . Results : There was not a significant difference in the percentage of responders in the Active compared with the Control group ( 95 % lower confidence bound ( LCB ) of −0.06 ; p = 0.55 ) . However , there was a significant difference in the percentage of patients that achieved a 30 % reduction ( p = 0.01 ) . Importantly , compared with sham-treated patients , there were also significant differences in reduction of number of headache days ( Active Group = 6.1 , baseline = 22.4 ; Control Group = 3.0 , baseline = 20.1 ; p = 0.008 ) , migraine-related disability ( p = 0.001 ) and direct reports of pain relief ( p = 0.001 ) . The most common adverse event was persistent implant site pain . Conclusion : Although this study failed to meet its primary endpoint , this is the first large-scale study of PNS of the occipital nerves in CM patients that showed significant reductions in pain , headache days , and migraine-related disability . Additional controlled studies using endpoints that have recently been identified and accepted as clinical ly meaningful are warranted in this highly disabled patient population with a large unmet medical need . Trial registration : Clinical trials.gov ( NCT00615342 ) Background and Purpose Behavioral medicine interventions that directly reduce arousal and negative emotions , such as relaxation training ( RT ) , are conceptually different from interventions that temporarily increase negative emotions , such as written emotional disclosure ( WED ) , but no studies have directly compared their efficacy . We compared the effects of RT and WED on people with tension or migraine headaches . Methods College students with either tension ( n = 51 ) or migraine ( n = 90 ) headaches were r and omized to one of three groups : RT , WED , or a neutral writing control condition ; four sessions were held over 2 weeks . Mood was measured before and after each session , and outcomes ( headache frequency , severity , disability , and general physical symptoms ) were assessed at baseline and at 1-month and 3-month follow-ups . Results As expected , RT led to an immediate increase in calmness , whereas WED led to an immediate increase in negative mood , for both headache sample s. Intent-to-treat analyses showed that , for the tension headache sample , RT led to improved headache frequency and disability compared to both WED and the control group , but WED had no effect . For migraine headaches , RT improved pain severity relative to the control group , but WED again had no effect . Conclusions A brief RT protocol was effective for tension headaches , but WED had no effect on health status for either tension or migraine headaches . Modifications to WED , such as targeting people with unresolved stress , providing guidance to enhance the potency of the writing , or including additional at-home writing and exposure exercises , may improve its efficacy for people with headaches and other health problems Background Modification of expectancies ( headache self-efficacy and headache locus of control ) is thought to be central to the success of psychological treatments for migraine . Purpose The purpose of this study is to examine expectancy changes with various combinations of Behavioral Migraine Management and migraine drug therapies . Methods Frequent migraine sufferers who failed to respond to 5 weeks of optimized acute migraine drug therapy were r and omized to a 2 ( Behavioral Migraine Management+ , Behavioral Migraine Management− ) × 2 ( β-blocker , placebo ) treatment design . Results Mixed models for repeated measures analyses ( N = 176 ) revealed large increases in headache self-efficacy and internal headache locus of control and large decreases in chance headache locus of control  with Behavioral Migraine Management+ that were maintained over a 12-month evaluation period . Chance headache locus of control and socioeconomic status moderated changes in headache self-efficacy  with Behavioral Migraine Management+ . Conclusions The “ deficiency ” hypothesis best explained how patient characteristics influenced changes in of headache self-efficacy with Behavioral Migraine Management In view of the association between chronic headaches and depression , this study compared a cognitive therapy package design ed for depression with a relatively st and ard behavioural treatment package design ed for headaches ( self-management training ) , in terms of their effects on headaches and depressive symptoms . Fifty-five subjects suffering from chronic headaches ( tension , migraine and combined ) were r and omly assigned to the two treatment conditions . Cognitive therapy and self-management training were equally effective at decreasing headaches and depressive symptoms on most measures . Changes in headaches and depressive symptoms were not significantly correlated in either condition , however . Greater headache improvement was associated with high pre-treatment headache activity for both conditions but , whilst self-management training was more effective for subjects low on depression , cognitive therapy was more effective for subjects high on chronicity . This suggests that the latter approach , or some variation of it , may be the treatment of choice for more chronic headache sufferers with depressive symptoms BACKGROUND Sleep problems have been linked with headaches for more than a century , but whether the headaches are the cause or the result of the disrupted sleep is unknown . OBJECTIVES We previously reported that nonrestorative sleep and poor sleep habits are almost universal in a referral population of women with transformed migraine ( TM ) . Since cognitive behavioral therapy is effective in improving sleep quality in individuals with poor sleep hygiene , we design ed a r and omized , placebo-controlled study to assess the impact of such treatment on TM . We hypothesized that behavioral sleep modification ( BSM ) would be associated with improvement in headache frequency and intensity and with reversion to episodic migraine . METHODS Subjects were 43 women with TM referred to an academic headache center . After obtaining informed consent , patients were r and omized to receive either behavioral sleep instructions or placebo behavioral instructions in addition to usual medical care . Subjects recorded headaches in st and ardized diaries . The first postintervention visit was scheduled at 6 weeks . At that visit , the blind was broken and all subjects received BSM instructions . A final visit was scheduled 6 weeks later . RESULTS Compared to the placebo behavioral group , the BSM group reported statistically significant reduction in headache frequency [ F ( 1 , 33 = 12.42 , P=.001 ) ] and headache intensity [ F(1 , 33 = 14.39 , P= .01 ) ] . They were more likely to revert to episodic migraine chi2 ( 2 , n = 43 ) = 7.06 , P= .029 . No member of the control group reverted to episodic migraine by the first postintervention visit . By the final visit , 48.5 % of those who had received BSM instructions had reverted to episodic migraine . CONCLUSIONS In this pilot study of women with TM , we found that a targeted behavioral sleep invention was associated with improvement in headache frequency , headache index , and with reversion to episodic migraine Abstract Introduction . Multimodal approaches in behavioral treatment have gained recent interest , with proven efficacy for migraine . The utility of the Internet has been demonstrated for behavioral treatment of headache disorders , but not specifically for migraine . The aim of the study was to develop and evaluate an Internet-based multimodal behavior treatment ( MBT ) program for migraine and to test h and massage treatment as an adjunct . Methods . Eighty-three adults , 58 women and 25 men , with at least two migraine attacks a month were recruited via advertisements . An MBT program aim ing at improvements in life-style and stress coping was developed for this study and , together with a diary , adapted for use over the Internet . Participants were r and omized to MBT with and without h and massage and to a control group , and were followed for 11 months . Question naires addressing issues of quality of life ( PQ23 ) and depressive symptoms ( MADRS-S ) were used . Results . A 50 % , or greater , reduction in migraine frequency was found in 40 % and 42 % of participants of the two groups receiving MBT ( with and without h and massage , respectively ) , who statistically were significantly more improved than participants in the control group . No effect of  h and massage  was detected , and gender did not show any independent contribution to the effect in a multivariate analysis . Conclusions . MBT administered over the Internet appears feasible and effective in the treatment of migraine , but no effect of h and massage was found . For increased knowledge on long-term effects and the modes of action of the present MBT program , further studies are needed BACKGROUND Chronic migraine ( CM ) and medication overuse headache ( MOH ) are disabling conditions that may be only partially managed with conservative treatments . Occipital nerve stimulation ( ONS ) is an innovative treatment for headache disorders . OBJECTIVES To investigate the safety and efficacy of ONS for CM and MOH patients and to evaluate changes in disability , quality of life , and drug intake in implanted patients . STUDY DESIGN Prospect i ve , r and omized cross-over study . METHODS Eligible patients who responded to a stimulation trial underwent device implantation and were r and omized to " Stimulation On " and " Stimulation Off " arms . Patients crossed over after one month , or when their headaches worsened . Stimulation was then switched On for all patients . Disability as measured by the Migraine Disability Assessment ( MIDAS ) , quality of life ( SF-36 ) , and drug intake ( patient 's diary ) were assessed over a one-year follow-up . RESULTS Thirty-four patients ( 76 % women , 34 % men , mean age : 46 ± 11 years ) were enrolled ; 30 were r and omized and 29 completed the study . Headache intensity and frequency were significantly lower in the On arm than in the Off arm ( p < 0.05 ) and decreased from the baseline to each follow-up visit in all patients with Stimulation On ( median MIDAS A and B scores : baseline = 70 and 8 ; one-year follow-up = 14 and 5 , p < 0.001 ) . Quality of life significantly improved ( p < 0.05 ) during the study . Triptans and nonsteroidal anti-inflammatory drug use fell dramatically from the baseline ( 20 and 25.5 doses/month ) to each follow-up visit ( 3 and 2 doses/month at one year , p < 0.001 ) . A total of 5 adverse events occurred : 2 infections and 3 lead migrations . LIMITATIONS Single-centre study , relatively small number of patients , absence of a control group . CONCLUSIONS According to the results obtained , ONS appears to be a safe and effective treatment for carefully selected CM and MOH patients Self-efficacy is posited in social cognitive theory as fundamental to behavior change . Few health behavior studies have examined self-efficacy prospect ively , viewed it as part of a reciprocal behavioral process , or compared self-efficacy beliefs in the same population across different behaviors . This article first discusses self efficacy in its theoretical context and review s the available prospect i ve studies . Second , it explores self-efficacy as a predictor of disease management behaviors in 570 older women with heart disease . Although the R 2 statistics in each case were modest , the construct is shown to be a statistically significant ( p < .05 ) predictor at both 4 and 12 months postbaseline of several disease management behaviors : using medicine as prescribed , getting adequate exercise , managing stress , and following a recommended diet .  Building self- 
    Output:
    
There was no evidence for either short-term or intermediate-term effectiveness of therapeutic patient education on self-efficacy or depressive symptoms .
This systematic review revealed strong-moderate evidence for intermediate-term effectiveness of therapeutic patient education for migraine .