Music medicine to improve the tolerability of onabotulinumtoxinA injections for chronic migraine: An open-label prospective cohort study

Jason Ray, Subahari Raviskanthan

Research output: Contribution to journalArticleResearchpeer-review


Introduction OnabotulinumtoxinA for migraine involves 31 injected repeated every 12 weeks. Tolerability is a significant factor impacting discontinuation. Music medicine has not been studied previously as an intervention to improve the tolerability of injections. Methodology A single-centre prospective cohort study was undertaken. Following baseline, patients had music played during the procedure. Change in Visual Analogue Score (VAS) was assessed as the primary outcome. Results Over 6 months, 50 patients were recruited with a median age of 42, and median duration of therapy of 13.5 months. 'Quiet calm classical music' was associated with a significant reduction in VAS (z=-4.7, p<0.001). Duration of therapy, disease state or headache frequency had no correlation with change in VAS. Conclusion Music medicine is associated with a significant reduction in the procedural pain of onabotulinumtoxinA injections in prospective study. Further study is required to explore other modifiable factors to improve patient experience.

Original languageEnglish
Article numbere000492
Number of pages3
JournalBMJ Neurology Open
Issue number2
Publication statusPublished - Sept 2023



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