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Self-Hypnosis Training for Migraine Management (HYlaMI): A Pilot and Proof-of-Concept Study (HYlaMI)
Self-Hypnosis Training for Migraine Management (HYlaMI): A Pilot and Proof-of-Concept Study of the Intervention Program (ORBIT Phase IIa-IIb)
Migraine is one of the most common and disabling neurological conditions worldwide, affecting approximately 1 billion people. Available pharmacological treatments have significant limitations (side effects, contraindications, medication overuse), highlighting the need for effective non-pharmacological alternatives.
The HYlaMI program (Self-Hypnosis Training for Migraine Management) is an 8-session group-based telehealth intervention adapted from HYlaDO, a self-hypnosis program developed for chronic pain management at the Hôpital Maisonneuve-Rosemont Pain Clinic (Montréal, Canada). Building on a refinement study conducted in autumn 2025 (CER: 2026-4061), HYlaMI combines heterohypnosis (guided by a trained clinician) and self-hypnosis (practiced autonomously at home using audio recordings) through weekly one-hour video sessions (Zoom/CIUSSS EMTL platform).
This study combines ORBIT Phase IIa (proof of concept) and Phase IIb (pilot study) objectives. The primary aims are to evaluate the feasibility of the HYlaMI program (retention and adherence rates) and to assess whether it can generate a clinically significant change in migraine-related disability compared to a waitlist control group. Secondary aims include evaluating effects on anxiety and depressive symptoms, pain self-efficacy, situational pain/anxiety/relaxation, migraine frequency, intensity and duration, medication intake, work absenteeism, quality of life, and the economic burden of migraine.
A mixed-methods design will be used. Forty adults with a diagnosis of migraine for more than one year will be randomized to either the HYlaMI intervention group (n=20) or a waitlist control group (n=20). Participants will complete validated questionnaires at multiple time points (pre-intervention, mid-intervention, post-intervention, and 4-week follow-up), a weekly migraine diary, and self-hypnosis practice logs. Two semi-structured focus groups will be conducted with intervention group participants to inform program improvement.
If successful, this study will provide the evidence base required to proceed to a larger randomized controlled trial (ORBIT Phase III).
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Background.
Migraine affects approximately 1.04 billion individuals worldwide and is associated with substantial socioeconomic burdens, including reduced quality of life, mental health comorbidities (anxiety, depression), and productivity losses. Non-pharmacological interventions, including clinical hypnosis, represent a growing area of investigation.
Intervention.
The HYlaMI program consists of 8 weekly one-hour group sessions delivered via teleconference (Zoom, CIUSSS EMTL platform). Seven hypnotic exercises are introduced sequentially, each following a standard hypnotic structure (induction, deepening, hypnotic work, post-hypnotic suggestions, return to waking state):
- Session 1: Psychoeducation on medical hypnosis and pain + "Pleasant place" exercise
- Session 2: "Backpack" exercise (anxiety and emotion management)
- Session 3: "Doing nothing" exercise (pain acceptance, catastrophizing)
- Session 4: "Thermal object" exercise (pain perception modification)
- Session 5: "Magic hand" exercise (analgesic suggestion)
- Session 6: "Rossi method" (resource-based pain relief)
- Session 7: "Reconnecting with a resource" (introspection and self-efficacy)
- Session 8: Conclusion, self-hypnosis prescription and 30 minutes Focus group on Social Validity of the intervention
A 9th session (1h-Focus group on Self-hypnosis practice+ follow-up meeting) is held 4 weeks post-intervention.
All 7 hypnotic exercises are provided as high-quality audio recordings to enable home self-hypnosis practice between sessions.
Study Design
Mixed-methods pilot and proof-of-concept study with two parallel arms: HYlaMI intervention group and waitlist control group. Randomization is performed using an online random group generator. For ethical reasons, waitlist participants will receive the full intervention after study completion.
Outcome Assessment Schedule
14 measurement time points are planned: T-1 and T0 (pre-intervention baseline), T1-T8 (weekly during intervention), and T9-T12 (weekly post-intervention follow-up).
Hypnotizability
Baseline hypnotizability is assessed using the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A), French online version, and will be used as a covariate in all analyses.
Data Management
Electronic questionnaires are managed via REDCap (CIUSSS EMTL server). Paper journals are used for in-session measures. Focus groups are recorded via Zoom, transcribed using OneDrive Word, and analyzed with NVivo 12.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: David Ogez, PhD
- Telefoonnummer: 4443 +1 514 252-3400
- E-mail: david.ogez@umontreal.ca
Studie Contact Back-up
- Naam: Eloise Cardinal, PhD Student
- Telefoonnummer: 514 895-7976
- E-mail: Eloise.cardinal@umontreal.ca
Studie Locaties
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Quebec
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Montreal, Quebec, Canada, H1T 2M4
- Centre de recherche de l'Hôpital Maisonneuve-Rosemont (CR-HMR)
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Contact:
- David Ogez, PhD
- Telefoonnummer: 4443 514 252-3400
- E-mail: david.ogez@umontreal.ca
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Formal diagnosis of migraine for more than one year (physician-issued; self-reported diagnosis accepted)
- French-speaking
- No consumption of alcohol or recreational drugs on the morning before group hypnosis sessions (migraine rescue medication is accepted but must be reported if taken before a session)
- Reliable internet connection
- Available to follow the 2.5-month self-hypnosis training program
Exclusion Criteria:
- Sensory or cognitive impairments that would interfere with comprehension (e.g., deafness)
- Severe, unstabilized neurological or psychiatric disorder that impairs communication
- Previous psychological treatment using hypnosis techniques for pain management
- Current participation in another psychological intervention (potential confounder for anxiety/depression outcomes)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Geen tussenkomst: Waitlist control group
Participants assigned to the waitlist control group do not receive the HYlaMI intervention during the study period.
They complete the same electronic questionnaires and weekly migraine diaries as the intervention group.
For ethical reasons, they will receive the full HYlaMI intervention after study completion.
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Experimenteel: HYlaMI Intervention Group
Participants assigned to the HYlaMI group attend 8 weekly group telehealth sessions and practice self-hypnosis at home using provided audio recordings.
They complete paper journals (in-session EVA ratings and qualitative feedback), weekly electronic migraine diaries, weekly self-hypnosis practice logs, and all standardized questionnaires at designated time points.
They participate in two semi-structured focus groups (T8 and T12).
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Eight weekly one-hour group telehealth sessions (Zoom/CIUSSS EMTL platform) delivering 7 complementary self-hypnosis exercises targeting migraine-related pain, stress, anxiety, and psychological resources.
Each session follows a standardized hypnotic structure.
High-quality audio recordings of all exercises are provided to participants for home self-hypnosis practice.
A clinician-researcher (doctoral candidate in neuropsychology, trained in hypnosis) leads all sessions using a standardized clinician manual.
A concluding focus group and follow-up session is held 4 weeks post-intervention.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Migraine-related disability - Migraine Disability Assessment (MIDAS)
Tijdsspanne: One-week-pre-intervention (T0) and 4-week post-intervention follow-up (4-weeks-post-intervention: T12)
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5-item scale quantifying the number of days affected by migraine in the past 3 months, generating a disability grade (I-IV).
Clinically significant improvement defined as a reduction of ≥5 points (grade III, initial score 11-20) or ≥30% (grade IV, initial score >20), per American Headache Society (2019) criteria.
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One-week-pre-intervention (T0) and 4-week post-intervention follow-up (4-weeks-post-intervention: T12)
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Migraine-related disability - Headache Impact Test (HIT-6)
Tijdsspanne: One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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6-item scale (score range 36-78) assessing headache impact on daily functioning.
Clinically significant improvement defined as a reduction of ≥5 points, per American Headache Society (2019) criteria.
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One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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Program feasibility - Retention and adherence rates
Tijdsspanne: Throughout intervention (first to 8th week of intervention: T1-T8)
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Descriptive analysis of session attendance (target: ≥6/8 sessions) and attrition rate (target: ≤15%), based on the HYlaDO pilot study.
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Throughout intervention (first to 8th week of intervention: T1-T8)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Anxiety and depressive symptoms
Tijdsspanne: One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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Hospital Anxiety and Depression Scale (HADS)
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One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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Pain self-efficacy
Tijdsspanne: One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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Pain Self-Efficacy Questionnaire (PSEQ)
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One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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Situational pain
Tijdsspanne: Before and after each hypnosis session (First to 7th week of intervention : T1-T7)
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Visual Analog Scale (VAS), 0-10
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Before and after each hypnosis session (First to 7th week of intervention : T1-T7)
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Situational anxiety
Tijdsspanne: Before and after each hypnosis session (First to 7th week of intervention : T1-T7)
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Visual Analog Scale (VAS), 0-10
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Before and after each hypnosis session (First to 7th week of intervention : T1-T7)
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Situational relaxation
Tijdsspanne: Before and after each hypnosis session (First to 7th week of intervention: T1-T7)
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Visual Analog Scale (VAS), 0-10
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Before and after each hypnosis session (First to 7th week of intervention: T1-T7)
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Migraine frequency
Tijdsspanne: Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12 )
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Weekly migraine diary (number of migraine days per week)
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Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12 )
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Measure: Migraine intensity
Tijdsspanne: Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Weekly migraine diary (average intensity, 0-10)
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Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Migraine duration
Tijdsspanne: Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Weekly migraine diary (duration in minutes)
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Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Medication intake
Tijdsspanne: Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Weekly migraine diary (type, dose, number of tablets)
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Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Work/school absenteeism
Tijdsspanne: Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Weekly migraine diary (number of absent days)
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Weekly (2-weeks-pre-intervention to 4-weeks-post-intervention: T-1 to T12)
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Quality of life economics
Tijdsspanne: One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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EQ-5D (5 dimensions + VAS, score 0-1 and 0-100)
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One-week-pre-intervention (T0), mid-intervention (week 4: T4), end of intervention (week 8: T8), and 4-week follow-up (4-weeks-post-intervention: T12)
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Economic burden of migraine
Tijdsspanne: 6th week of intervention and 4-weeks-post-intervention follow-up (T6, T12)
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Cost in health questionnaire (direct and indirect costs)
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6th week of intervention and 4-weeks-post-intervention follow-up (T6, T12)
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Program improvement
Tijdsspanne: T8 (end of intervention) and T12 (4-week follow-up)
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Qualitative thematic analysis of two semi-structured focus groups
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T8 (end of intervention) and T12 (4-week follow-up)
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Medewerkers en onderzoekers
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
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Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Pijn
- Neurologische manifestaties
- Hersenziekten
- Ziekten van het centrale zenuwstelsel
- Ziekten van het zenuwstelsel
- Hoofdpijnaandoeningen, primair
- Hoofdpijn aandoeningen
- Pathologische aandoeningen, tekenen en symptomen
- Tekenen en symptomen
- Migraine-stoornissen
- Chronische pijn
- Therapeutica
- Mind-body therapieën
- Complementaire therapieën
- Psychotherapie
- Gedragsdisciplines en activiteiten
- Hypnose
Andere studie-ID-nummers
- CEMTL 2026 4353
Plan Individuele Deelnemersgegevens (IPD)
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