Add-on deep Transcranial Magnetic Stimulation (dTMS) for the treatment of chronic migraine: A preliminary study

Rapinesi, Chiara; Casale, Antonio Del; Scatena, Paola; Kotzalidis, Georgios D.; Pietro, Simone Di; Ferri, Vittoria Rachele; Bersani, Francesco Saverio; Brugnoli, Roberto; Raccah, Ruggero; Zangen, Abraham; Ferracuti, Stefano; Orzi, Francesco; Girardi, Paolo; Sette, Giuliano

doi:10.1016/j.neulet.2016.04.058

Cited by 30 publications

(28 citation statements)

References 15 publications

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“…There were a total of 34 studies included in the descriptive synthesis. Of those, 22 were TMS (16 rTMS) and 12 were tDCS articles (Supplementary Materials – Study Characteristics Tables). A comparison of defining study parameters is outlined below.…”

Section: Resultsmentioning

confidence: 99%

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Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

et al. 2019

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Background Headache is among the most prevalent causes of disability worldwide. Non‐pharmacologic interventions, including neuromodulation therapies, have been proposed in patients who are treatment resistant or intolerant to medications. Objective To perform a systematic review on the use of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) for the treatment of specific headache disorders (ie, migraine, tension, cluster, posttraumatic). Methods Data sources: Ovid MEDLINE, Cochrane Central Register of Clinical Trials, Embase, Scopus, PsycINFO. Data extraction: All references were reviewed by 2 independent researchers (3039 abstracts, duplicates removed). Records were selected by inclusion criteria for participants (adults 18‐65 with primary or secondary headaches), interventions (TMS and tDCS applied as headache treatment), comparators (sham or alternative standard of care), and study type (cohort, case‐control, and randomized controlled trials [RCT]). Studies were assessed using the Cochrane Risk of Bias Tool and overall quality determined through the GRADE Tool. A structured synthesis was performed due to heterogeneity of participants and methods. Results Thirty‐four studies were included: 16 rTMS, 6 TMS (excluding rTMS), and 12 tDCS. The majority investigated treatment for migraine (19/22 TMS, 8/12 tDCS). Quality of evidence ranged from very low to high. Conclusion Of all TMS and tDCS modalities, rTMS is most promising with moderate evidence that it contributes to reductions in headache frequency, duration, intensity, abortive medication use, depression, and functional impairment. However, only few studies reported changes greater than sham treatment. Further high‐quality RCTs with standardized protocols are required for each specific headache disorder to validate a treatment effect. Registration Number: PROSPERO 2017 CRD42017076232.

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Section: Resultsmentioning

confidence: 99%

“…Twelve TMS studies (9 rTMS, 2 sTMS, and 1 dTMS) were randomized trials. The remaining 10 were either non‐randomized controlled or prospective cohort/open label trials .…”

Section: Resultsmentioning

confidence: 99%

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

et al. 2019

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“…In this context, it is interesting to note that openness was associated with increased response to placebo analgesia in migraineurs (58) and with better response to both pharmaco- and psychotherapy in depressed people (59). Furthermore, deep transcranial magnetic stimulation of the DLPFC significantly reduced both frequency and intensity of migraine attacks and depressive symptoms (60). …”

Section: Discussionmentioning

confidence: 99%

Decreased Openness to Experience Is Associated with Migraine-Type Headaches in Subjects with Lifetime Depression

et al. 2017

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IntroductionMigraine and depression frequently occur as comorbid conditions, and it has been hypothesized that migraine with and without depression may have a different genetic background. A distinct personality trait constellation has been described in migraineurs. Less attention, however, was paid to personality differences in migraineurs with and without depression which may also shed light on differences in the neurobiological, background. The aim of our study was to investigate big five personality traits, headaches, and lifetime depression (DEP) in a large European general population sample.MethodsRelationship between DEP, Big Five Inventory personality traits, and headaches identified by the ID-Migraine Questionnaire were investigated in 3,026 individuals from Budapest and Manchester with multivariate and logistic regression analyses.ResultsBoth DEP and migraine(ID) showed differences in personality traits. Neuroticism was an independent risk factor for both conditions while a significant interaction effect appeared between the two in the case of openness. Namely, subjects with migraine(ID) and without DEP scored higher on openness compared to those who had depression.ConclusionWhile we confirmed previous results that high neuroticism is a risk factor for both depression and migraine, openness to experience was significantly lower in the co-occurrence of migraine and depression. Our results suggest that increased openness, possibly manifested in optimal or advantageous cognitive processing of pain experience in migraine may decrease the risk of co-occurrence of depression and migraine and thus may provide valuable insight for newer prevention and intervention approaches in the treatment of these conditions.

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“…24 Four articles with a total of 115 participants explored the effects of tDCS on migraineurs, [28][29][30][31] of which 3 studies used anodal tDCS 28,29,31 and 1 study used cathodal tDCS. 26,31 Results of Meta-Analysis and Sensitivity Analysis.-The results of meta-analysis and subsequent sensitivity analysis are summarized in Table 3. The mean score of included studies was 7.00, ranging from 6 to 9.…”

Section: Identification and Selection Of Studies-the Detailsmentioning

confidence: 99%

“…15,26,27 Meta-analysis based on these studies showed a statistically significant effect with a large effect size on headache intensity (Hedges' g = −1.14; 95% CI, −2.21 to −0.07; P = .04, Fig. 15,26,27 Meta-analysis based on these studies showed a statistically significant effect with a large effect size on headache intensity (Hedges' g = −1.14; 95% CI, −2.21 to −0.07; P = .04, Fig.…”

Section: Identification and Selection Of Studies-the Detailsmentioning

confidence: 99%

Effects of Non‐invasive Brain Stimulation on Headache Intensity and Frequency of Headache Attacks in Patients With Migraine: A Systematic Review and Meta‐Analysis

Feng

Zhang

et al. 2019

Headache

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Background Non‐invasive brain stimulation (NIBS) techniques such as repetitive transcranial magnetic stimulation (rTMS), as well as transcranial direct current stimulation (tDCS) electrically stimulate the brain and modify brain activity to suppress pain. This method is emerging as a potential clinical intervention against migraine. Objective To quantitatively review the efficacy of rTMS and tDCS in randomized controlled trials (RCTs) in modifying headache intensity and frequency of headache attacks in patients suffering from migraine. Methods We searched 5 databases: PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus for articles from January 2000 to September 2018. Any RCT regarding the efficacy on rTMS and tDCS on patients with migraine, was considered to be included. A random effects meta‐analysis was performed to pool effect sizes of outcomes related to headache intensity or frequency of headache attacks. The methodological quality of the included RCTs was assessed using the Physiotherapy Evidence Database scale. Results Nine RCTs with 276 participants in total (experimental group [EG] = 149; control group [CG] = 127) were included in this review. Five included articles used rTMS (EG = 81; CG = 80), and 4 used tDCS (EG = 68; CG = 47). Meta‐analysis of excitatory primary motor cortex (M1) stimulation showed significant effects on reducing headache intensity in patients with migraine (Hedges' g = −0.94; 95% CI, −1.28 to −0.59; P < .001, I2 = 18.39%) with a large effect size. Meta‐analysis of excitatory M1 stimulation showed significant effects on reducing frequency of headache attacks in patients with migraine, with a large effect size (Hedges' g = −0.88; 95% CI, −1.38 to −0.38; P = .001, I2 = 57.15%). Excitatory dorsolateral prefrontal cortex stimulation showed a significant effect on the headache intensity in patients with migraine (Hedges' g = −1.14; 95% CI, −2.21 to −0.07; P = .04, I2 = 61.86%) with a large effect size. However, reductions of frequency of headache attacks was not significant. Limitations Potential differential effects of rTMS and tDCS, various sham methods, and potential overlapping headache disorders among included subjects may affect the estimation of effect sizes. Conclusion Excitatory NIBS of the M1 is likely to reduce headache intensity and the frequency of headache attacks in patients with migraine.

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Add-on deep Transcranial Magnetic Stimulation (dTMS) for the treatment of chronic migraine: A preliminary study

Cited by 30 publications

References 15 publications

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

Decreased Openness to Experience Is Associated with Migraine-Type Headaches in Subjects with Lifetime Depression

Effects of Non‐invasive Brain Stimulation on Headache Intensity and Frequency of Headache Attacks in Patients With Migraine: A Systematic Review and Meta‐Analysis

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