A systematic review of high-frequency transcranial magnetic stimulation on motor cortex areas as a migraine preventive treatment

Abstract

Background: The results of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex for migraine have been inconsistent. However, high-frequency rTMS over the motor cortex is a treatment that may be effective in relieving symptoms of migraine with a low risk of side effects. Methods: A systematic review of high-frequency rTMS over the brain motor cortex areas in human participants was conducted to assess efficacy in treating migraine. Articles that were not looking at migraine patients, stimulation over the left motor cortex, or were not in English were excluded. Nine articles representing eight experiments using high-frequency rTMS over the motor cortex areas for migraine in human participants were extracted from the databases of PubMed, PsycINFO, MedLine, CINAHL, and BioMed Central. Results: Two-hundred and seven of 213 patients completed treatment throughout all the studies examined. High-frequency rTMS over the motor cortex areas for migraine improved migraine frequency in seven of eight studies. Two of the eight studies were randomized controlled trials at low risk for biases and found high-frequency rTMS over the motor cortex areas effective in improving migraine frequency and severity. Other details of treatment prescription and symptoms were also examined. Conclusion: High-frequency rTMS over the motor cortex areas for migraine demonstrated efficacy as a migraine treatment, had minimal side effects, and should be further investigated.

Repetitive Transcranial Magnetic Stimulation of the Primary Motor Cortex beyond Motor Rehabilitation: A Review of the Current Evidence

“…Recent systematic reviews and meta-analyses have converged on the promising contribution of M1-rTMS in reducing headache frequency, intensity, duration, abortive medication use, and functional impairment in both episodic and chronic migraine [ 89 , 90 , 91 , 92 , 93 ]. The preferred TMS parameters in the meta-analysis of Moisset et al were high-frequency (10 Hz) rTMS applied over the left M1, with 600–3000 pulses per session, stimulation intensity at 70–80% RMT, and for 1–10 sessions [ 91 ].…”

Update of Neuromodulation in Chronic Migraine

“…Although demonstrating a good safety profile, rTMS remains investigational for pain disorder, post-traumatic headache, and primary headache disorders. Based on two recent systematic reviews, high-frequency rTMS over the motor cortex demonstrated efficacy as a migraine treatment, but further high-quality RCTs with a standardized protocol are required to validate a treatment effect [23,33].…”

Exploring the Therapeutic Potential of Quadripulse rTMS over the Visual Cortex: A Proof-of-Concept Study in Healthy Volunteers and Chronic Migraine Patients with Medication Overuse Headache

“…Up to now, rTMS trials in CM-MOH have used activating high stimulation rates (10 or 20 Hz) and targeted either the dorsolateral prefrontal cortex (DLPFC) [19][20][21] or the primary motor cortex [22], yielding conflicting results [20,21,23]. A meta-analysis on the subject was published recently [24].…”