Increased migraine-free intervals with multifocal repetitive transcranial magnetic stimulation

Abstract

Conclusion: Our pilot study shows compelling evidence in a double placebo-controlled trial that multifocal rTMS is an effective and well-tolerated preventive treatment in patients with episodic migraine.

Effects on neuromodulation, acupuncture, and aerobic exercises on migraine and tension-type headache outcomes: A systematic review and meta-analysis

“…Most of the unclear ratings were due to the unavailability of a study protocol; hence, unclear selective outcome reporting was a source of bias. [13–17,19,23,30,31,35,36,38,42] The unclear risk of bias was also attributed to “other bias”: the lack of sufficient evidence for judging the other risk of bias. [18,23,29,30,34,39–42] The ROB most frequently rated as “high” was “blinding of participants and personnel.” [17,19,21–23,31,32,34,37,39–42] In some trials, such as those on aerobic exercises and waitlist, it was impossible to implement blinded methods.…”

“…Of the twenty-seven included studies, nineteen investigated the effect of interventions for migraine [13][14][15][16][17][18][19]21,[29][30][31][32][33][34][35][36][37] and 7 for TTH. [23,[38][39][40][41][42] One study [22] investigated both TTH and migraine using separate data analyses.…”

“…[23,[38][39][40][41][42] One study [22] investigated both TTH and migraine using separate data analyses. Fourteen studies focused on acupuncture, [17][18][19]32,33,[37][38][39][40][41][42] 9 on neuromodulation therapy, [13][14][15][16]30,31,35,36,42] and 4 on aerobic exercise. [21][22][23]34] The specific characteristics of the selected studies are described in Table 2.…”

“…Another source of high risk of bias was the concealment of allocation protocol. [13,17,18,[29][30][31][35][36][37][38][39][40][41][42] Some trials were open to random allocation and some were alternate enrollment. [18,31,32,34] The Kappa coefficient was 0.63 (P < .001), indicating moderate agreement on the bias analysis between the 2 analysts (PCH and LYL).…”

New updates on transcranial magnetic stimulation in chronic pain

“…Other pain conditions have been studied with a potential benefit, yet uncertain benefit of M1 rTMS, such as musculoskeletal pain and complex regional pain syndrome (CRPS) of type I [31,46]. rTMS paradigms targeting more than one brain area has recently been used to treat episodic migraine [47]. This protocol reduced the number and intensity of migraine attacks compared with placebo treatment.…”