CClinicalTrials.gg
Not yet recruitingNCT07599228MIRAGEUpdated Sep 30, 2026

Using Virtual Reality to Teach Mindfulness to People With Migraine

An interventional study of ACT therapy delivered by REACT NeuroVR headset in Migraine Disorders, Migraine With Aura and Migraine Without Aura, sponsored by Brigham and Women's Hospital. Not yet recruiting at 3 sites in United States. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-09-30.

Sponsored by Brigham and Women's Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The aim of this clinical trial is to learn if people with migraine can learn a type of biobehavioral therapy called Acceptance and Commitment Therapy (ACT) by using a virtual reality headset. Researchers are studying if this type of mindfulness therapy helps to decrease migraine-related disability. Participants will be randomized to treatment as usual or active virtual reality groups for four weeks. Everyone will keep symptom diaries, complete surveys, attend two clinic visits, and have two blood draws.

Read the detailed description

This study is designed to evaluate the clinical utility of REACT NeuroVR in patients with episodic migraine who are already receiving stable CGRP monoclonal antibody therapy. By combining pharmacologic advances with digitally delivered psychological support, we aim to assess whether this integrated approach can further reduce headache frequency, improve migraine-specific quality of life, and reduce anticipatory anxiety. Additionally, we will explore changes in inflammatory biomarkers to examine potential physiologic correlates of intervention-related improvement.

Ultimately, this study addresses a critical gap in migraine care: the integration of effective, accessible behavioral health strategies into the treatment paradigm for patients who continue to experience burdensome symptoms despite preventive therapy.

1. Specific Aims and Objectives

Aim 1 (Pilot and Feasibility Study):

To evaluate the feasibility, acceptability, and usability of personalized Acceptance and Commitment Therapy (ACT) delivered via REACT NeuroVR. Focus groups with key stakeholders (patients, clinicians, and implementation experts) will be conducted to obtain feedback on intervention content, delivery, and outcome measures. Insights from this pilot phase will inform refinements to the intervention and study procedures for the subsequent full-scale clinical trial.

Aim 2 (Primary Efficacy Aim):

To determine whether personalized ACT therapy delivered via REACT NeuroVR reduces the number of monthly headache days in patients with episodic migraine compared to baseline.

Aim 3 (Psychological and Functional Outcomes):

To evaluate whether REACT NeuroVR improves migraine-specific quality of life and reduces anticipatory anxiety related to migraine events.

Aim 4 (Exploratory Biological and Sensory Aims):

To explore changes in inflammatory biomarkers.

Participants will:

Be randomized to treatment as usual or active VR participants Everyone who completes run-in will have a chance to try the VR device and have an additional screen.

Everyone will have a blood test at the beginning and the end of the study. Active participants will be loaned a VR device to take home for four weeks and will do the study activities as well as use a variety of experiences when they choose (such as beach visits, virtual ice baths and others) Participants will fill out surveys throughout the study.

Visit the clinic twice during the study Keep a diary of their symptoms and number of migraines

02

Conditions studied

  • Migraine Disorders
  • Migraine With Aura
  • Migraine Without Aura
  • Episodic Migraine

Keywords

  • acceptance and commitment therapy (ACT)
  • migraine
  • virtual reality
  • mindfulness
  • Calcitonin Gene-Related Peptide monoclonal antibody therapy
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adults aged 18-80
  • Diagnosed with episodic migraine and experience 4-10 migraine days/month
  • On a stable dose of CGRP mAb for three months prior
  • Satisfy 4 week run-in of 4-10 headaches/month
  • Not taking other preventive medications
  • Not pregnant, breastfeeding, or planning to become pregnant within study timeframe
  • Able and willing to use VR device
  • No history of significant psychiatric illness
  • Willing to comply with study procedures
  • English-speaking

Exclusion criteria

Exclusion Criteria:

  • Medication overuse (>10 days/month)
  • Vertigo/vestibular dysfunction
  • Active psychiatric or neurological comorbidities
  • Pregnancy, breastfeeding or planning pregnancy within study timeframe
  • Significant visual/hearing/mobility impairment affecting VR use
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
160 participants (estimated)

Study arms

  • No intervention
    Treatment as usual

    This group will remain on their CGRP injectable monoclonal antibody migraine preventive medication

  • Active comparator
    Active Treatment

    This group will participate in the four week active virtual reality treatment and will also remain on their CGRP mAb medication.

    Behavioral: ACT therapy delivered by REACT NeuroVR headset

Interventions

  • BehavioralACT therapy delivered by REACT NeuroVR headset

    This is ACT/mindfulness therapy delivered via a virtual reality headset.

05

What researchers measure

Primary outcomes

  1. Phase one: Qualitative Interview of User Experience

    Assessment of user experience captured using open ended questions, yes/no questions, and a 4-point scale ranging from "Very Poor" to "Very Good".

    Time frame: 2 weeks

  2. Phase one: rate of participants using virtual reality for migraine-- qualitative data

    Assessment of how often and how long participants used the devices. Two 6-point scales included ranging from "Never" to "12-14 days" as well as "Under 10 minutes" to "More than 2 hours".

    Time frame: 2 weeks

  3. Phase two: Efficacy as described by number of headache days

    Time frame: 6 Months

Secondary outcomes

  1. Phase two: Headache Disability Inventory

    Assessment of acceptance and commitment (ACT) treatment on migraine-associated disability

    Time frame: 6 Months

  2. Phase two: Change in Inflammatory Biomarker panel-NULISAseq Inflammation 250

    Will be measuring serum samples prior to study and at 12-week time to assess for change

    Time frame: baseline and 12 weeks

  3. Anxiety and Depression

    Migraine related anxiety and depression will be assessed by PROMIS29

    Time frame: baseline and 12 weeks

06

Study locations

3 sites
  • Brigham and Womens Hospital
    Boston, Massachusetts 02155, United States
  • Brigham and Women's Health Care Center
    Chestnut Hill, Massachusetts 02467, United States
  • Brigham and Women's Hospital
    Chestnut Hill, Massachusetts 02467, United States
07

References and documents

Publications

  • Yamanaka G, Hayashi K, Morishita N, Takeshita M, Ishii C, Suzuki S, Ishimine R, Kasuga A, Nakazawa H, Takamatsu T, Watanabe Y, Morichi S, Ishida Y, Yamazaki T, Go S. Experimental and Clinical Investigation of Cytokines in Migraine: A Narrative Review. Int J Mol Sci. 2023 May 6;24(9):8343. doi: 10.3390/ijms24098343. PubMed 37176049 ↗
  • Viderman D, Tapinova K, Dossov M, Seitenov S, Abdildin YG. Virtual reality for pain management: an umbrella review. Front Med (Lausanne). 2023 Jul 14;10:1203670. doi: 10.3389/fmed.2023.1203670. eCollection 2023. PubMed 37521355 ↗
  • Thuraiaiyah J, Erritzoe-Jervild M, Al-Khazali HM, Schytz HW, Younis S. The role of cytokines in migraine: A systematic review. Cephalalgia. 2022 Dec;42(14):1565-1588. doi: 10.1177/03331024221118924. Epub 2022 Aug 12. PubMed 35962530 ↗
  • R P, S C N, S H, K R. Migraine Disability, Quality of Life, and Its Predictors. Ann Neurosci. 2020 Jan;27(1):18-23. doi: 10.1177/0972753120929563. Epub 2020 Jul 3. PubMed 32982095 ↗
  • P AS, S G. Acceptance and Commitment Therapy and Psychological Well-Being: A Narrative Review. Cureus. 2025 Jan 20;17(1):e77705. doi: 10.7759/cureus.77705. eCollection 2025 Jan. PubMed 39974259 ↗
  • Musubire AK, Cheema S, Ray JC, Hutton EJ, Matharu M. Cytokines in primary headache disorders: a systematic review and meta-analysis. J Headache Pain. 2023 Apr 4;24(1):36. doi: 10.1186/s10194-023-01572-7. PubMed 37016284 ↗
  • Aditya S, Rattan A. Advances in CGRP Monoclonal Antibodies as Migraine Therapy: A Narrative Review. Saudi J Med Med Sci. 2023 Jan-Mar;11(1):11-18. doi: 10.4103/sjmms.sjmms_95_22. Epub 2023 Jan 14. PubMed 36909005 ↗

Individual participant data

Plan to share: Yes — We will share demographics including age and sex within the BWH researchers.

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

08

Registry details

Key details

Study ID
NCT07599228
Lead sponsor
Brigham and Women's Hospital
Responsible party
Carolyn A. Bernstein (Lavine Family Endowed Chair in Neurology, Brigham and Women's Hospital) — Principal investigator
First posted
May 20, 2026
Start date
Sep 30, 2026 (estimated)
Primary completion
Aug 2029 (estimated)
Completion
Jan 2031 (estimated)
Last update
Sep 30, 2026

Study contacts

carolyn bernstein, MD
Contact
cabernstein@bwh.harvard.edu
6177329700
asimina lazaridou, PhD
Contact
alazaridou@bwh.harvard.edu
carolyn bernstein, MD
principal investigator · BWH

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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