Anodal transcranial direct current stimulation in chronic migraine and medication overuse headache: A pilot double-blind randomized sham-controlled trial

Icco, Roberto De; Putortì, Alessia; Paoli, Irene; Ferrara, EC; Cremascoli, Riccardo; Terzaghi, Michele; Toscano, Gianpaolo; Allena, Marta; Martinelli, Daniele; Cosentino, Giuseppe; Grillo, Valentina; Colagiorgio, P; Versino, Maurizio; Manni, Raffaele; Sances, Grazia; Sandrini, Giorgio; Tassorelli, Cristina

doi:10.1016/j.clinph.2020.10.014

Cited by 27 publications

(32 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Six RCTs assessed the efficacy of cathodal tDCS [ 18 , 20 , 22 , 28 – 30 ], five assessed the efficacy of anodal tDCS [ 19 , 21 , 23 , 24 , 27 ], and two of both techniques [ 25 , 26 ]. Figure 3 reports the montages used for tDCS in each RCT.…”

Section: Resultsmentioning

confidence: 99%

“…In four RCTs of anodal tDCS, the anode was positioned above M1, with varying sides (C3 or C4 electrodes), with contralateral supraorbital reference (Fp2 or Fp1 electrodes) [ 21 , 23 , 24 , 31 ]; one RCT placed anodes either above the left M1 or above the left dorsolateral prefrontal cortex (DLPFC; C3 or F3 electrodes, respectively), with contralateral supraorbital reference (Fp2) [ 19 ]; one RCT placed the anode over the left DLPFC (F3 electrode), with reference on the opposite side (F4 electrode) [ 26 ]; a further trial positioned the anode on the right M1 (C4 electrode) with left supraorbital reference (Fp1 electrode) [ 25 ]; the remaining RCT placed the anode above the occipital areas (Oz electrode) with central reference (Cz electrode) [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Which is the best transcranial direct current stimulation protocol for migraine prevention? A systematic review and critical appraisal of randomized controlled trials

et al. 2021

View full text Add to dashboard Cite

Background Transcranial direct current stimulation (tDCS) could counteract the pathophysiological triggers of migraine attacks by modulating cortical excitability. Several pilot randomized controlled trials (RCTs) assessed the efficacy of tDCS for migraine prevention. We reviewed and summarized the state of the art of tDCS protocols for migraine prevention, discussing study results according to the stimulations parameters and patients’ populations. Main body We combined the keywords ‘migraine’, ‘headache’, ‘transcranial direct current stimulation’, and ‘tDCS’ and searched Pubmed, Scopus, and Web of Science, from the beginning of indexing to June 22, 2021. We only included RCTs comparing the efficacy of active tDCS with sham tDCS to decrease migraine frequency, intensity, and/or acute drug utilization. The risk of bias of each RCT was assessed by using the RoB-2 tool (Cochrane Collaboration). Thirteen RCTs (from 2011 to 2021) were included in the review. The included patients ranged from 13 to 135. RCTs included patients with any migraine (n=3), chronic migraine (n=6), episodic migraine (n=3) or menstrual migraine (n=1). Six RCTs used cathodal and five anodal tDCS, while two RCTs compared the efficacy of both cathodal and anodal tDCS with that of sham. In most of the cathodal stimulation trials, the target areas were the occipital regions, with reference on central or supraorbital areas. In anodal RCTs, the anode was usually placed above the motor cortical areas and the cathode on supraorbital areas. All RCTs adopted repeated sessions (from 5 to 28) at variable intervals, while the follow-up length spanned from 1 day up to 12 months. Efficacy results were variable but overall positive. According to the RoB-2 tool, only four of the 13 RCTs had a low risk of bias, while the others presented some concerns. Conclusions Both anodal and cathodal tDCS are promising for migraine prevention. However, there is a need for larger and rigorous RCTs and standardized procedures. Additionally, the potential benefits and targeted neurostimulation protocols should be assessed for specific subgroups of patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Which is the best transcranial direct current stimulation protocol for migraine prevention? A systematic review and critical appraisal of randomized controlled trials

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Chronic pain requires long-term management; thus, accessibility, which helps patients adhere to the treatment protocol, is critical for achieving long-term changes in neural excitability and connection. In addition, tDCS effects have been shown to be optimized with new montages, more frequent number of session or longer treatment duration, as in studies lasting over 4 weeks ( 17 , 50 , 54 , 61 , 93 – 95 ). If these therapeutic approaches are implemented properly at home, these efforts could significantly increase and accelerate the clinical effect reported in tDCS trials.…”

Section: Value Of Home-based Hd-tdcsmentioning

confidence: 99%

The Concept, Development, and Application of a Home-Based High-Definition tDCS for Bilateral Motor Cortex Modulation in Migraine and Pain

et al. 2022

View full text Add to dashboard Cite

Whereas, many debilitating chronic pain disorders are dominantly bilateral (e.g., fibromyalgia, chronic migraine), non-invasive and invasive cortical neuromodulation therapies predominantly apply unilateral stimulation. The development of excitatory stimulation targeting bilateral primary motor (M1) cortices could potentially expand its therapeutic effect to more global pain relief. However, this is hampered by increased procedural and technical complexity. For example, repetitive transcranial magnetic stimulation (rTMS) and 4 × 1/2 × 2 high-definition transcranial direct current stimulation (4 × 1/2 × 2 HD-tDCS) are largely center-based, with unilateral-target focus—bilateral excitation would require two rTMS/4 × 1 HD-tDCS systems. We developed a system that allows for focal, non-invasive, self-applied, and simultaneous bilateral excitatory M1 stimulation, supporting long-term home-based treatment with a well-tolerated wearable battery-powered device. Here, we overviewed the most employed M1 neuromodulation methods, from invasive techniques to non-invasive TMS and tDCS. The evaluation extended from non-invasive diffuse asymmetric bilateral (M1-supraorbital [SO] tDCS), non-invasive and invasive unilateral focal (4 × 1/2 × 2 HD-tDCS, rTMS, MCS), to non-invasive and invasive bilateral bipolar (M1-M1 tDCS, MCS), before outlining our proposal for a neuromodulatory system with unique features. Computational models were applied to compare brain current flow for current laboratory-based unilateral M11 and bilateral M12 HD-tDCS models with a functional home-based M11−2 HD-tDCS prototype. We concluded the study by discussing the promising concept of bilateral excitatory M1 stimulation for more global pain relief, which is also non-invasive, focal, and home-based.

show abstract

“…Studies have shown that a treatment with tDCS on the M1 area causes long‐lasting relief in medication‐resistant patients with chronic pain syndrome such as trigeminal neuralgia, post‐stroke pain, back pain, and fibromyalgia 108,109 . The efficacy of tDCS in alleviating pain has also been shown in patients with multiple sclerosis joint pain, 110 neuropathic pain, 111 spinal cord injury, 112 fibromyalgia, 113 chronic migraine, 114 foot pain, 115 and intra‐abdominal pain 116 . A meta‐analysis studies further found that a treatment with tDCS reduces chronic pain intensity 47 …”

Section: Non‐invasive Brain Stimulationmentioning

confidence: 99%

Brain stimulation: a therapeutic approach for the treatment of neurological disorders

et al. 2021

View full text Add to dashboard Cite

Brain stimulation has become one of the most acceptable therapeutic approaches in recent years and a powerful tool in the remedy against neurological diseases. Brain stimulation is achieved through the application of electric currents using non‐invasive as well as invasive techniques. Recent technological advancements have evolved into the development of precise devices with capacity to produce well‐controlled and effective brain stimulation. Currently, most used non‐invasive techniques are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), whereas the most common invasive technique is deep brain stimulation (DBS). In last decade, application of these brain stimulation techniques has not only exploded but also expanded to wide variety of neurological disorders. Therefore, in the current review, we will provide an overview of the potential of both non‐invasive (rTMS and tDCS) and invasive (DBS) brain stimulation techniques in the treatment of such brain diseases.

show abstract

Anodal transcranial direct current stimulation in chronic migraine and medication overuse headache: A pilot double-blind randomized sham-controlled trial

Cited by 27 publications

References 62 publications

Which is the best transcranial direct current stimulation protocol for migraine prevention? A systematic review and critical appraisal of randomized controlled trials

Which is the best transcranial direct current stimulation protocol for migraine prevention? A systematic review and critical appraisal of randomized controlled trials

The Concept, Development, and Application of a Home-Based High-Definition tDCS for Bilateral Motor Cortex Modulation in Migraine and Pain

Brain stimulation: a therapeutic approach for the treatment of neurological disorders

Contact Info

Product

Resources

About