Magnetic stimulation of the upper trapezius muscles in patients with migraine – A pilot study

Sollmann, Nico; Trepte-Freisleder, Florian; Albers, Lucia; Jung, Nikolai H.; Mall, Volker; Meyer, Bernhard; Heinen, Florian; Krieg, Sandro M.; Landgraf, Mirjarm N.

doi:10.1016/j.ejpn.2016.07.022

Cited by 28 publications

(57 citation statements)

References 37 publications

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“…These previous results imply that rPMS could alleviate muscular sensitivity at the stimulated area as well as headache symptoms within the context of the TCC, making rPMS a promising neuromodulatory technique 44 . To date, rPMS offers an auspicious non-invasive neuromodulatory approach that can directly intervene at peripheral muscular structures in the neck and shoulder area whilst potentially using the TCC as a gateway to modulate central nociception simultaneously.…”

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confidence: 59%

“…According to the concept of the TCC, peripheral sensitization and central convergence of cervical and meningeal nociceptive afferents in the brain stem could explain the important correlation of neck pain and migraine [17][18][19] . To date, rPMS seems to be a promising non-pharmacological, non-invasive approach that allows modulation of peripheral as well as central migraine-related symptoms via peripheral inflow, which is most likely taking effect on the basis of the TCC 44 . In a pilot study, rPMS was applied to the trapezius muscles of young migraineurs, leading to a decrease of migraine attacks and intensity of headache 44 .…”

Section: Discussionmentioning

confidence: 99%

“…Promising examples include transcranial magnetic stimulation (TMS) [30][31][32][33] , transcranial direct current stimulation (tDCS) [34][35][36] , supra-orbital nerve stimulation (SONS) [37][38][39] , and vagus nerve stimulation (VNS) [40][41][42][43] . In addition, repetitive peripheral magnetic stimulation (rPMS) has been introduced recently as a novel method to stimulate the upper trapezius muscles in subjects with migraine, with its application being feasible, well-tolerated, and mostly free of any adverse effects among migraineurs 44 . Moreover, migraine frequency decreased substantially according to three-month follow-up after rPMS to trapezius muscles as assessed by the Migraine Disability Assessment (MIDAS) questionnaire 44 .…”

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confidence: 99%

“…In addition, repetitive peripheral magnetic stimulation (rPMS) has been introduced recently as a novel method to stimulate the upper trapezius muscles in subjects with migraine, with its application being feasible, well-tolerated, and mostly free of any adverse effects among migraineurs 44 . Moreover, migraine frequency decreased substantially according to three-month follow-up after rPMS to trapezius muscles as assessed by the Migraine Disability Assessment (MIDAS) questionnaire 44 . Of note, the local pressure pain threshold (PPT) of the trapezius muscles was steadily increasing during the course of the six sessions of rPMS applied in this previous study, indicating local muscular effects besides alleviation of headache symptoms 44 .…”

mentioning

confidence: 99%

“…Moreover, migraine frequency decreased substantially according to three-month follow-up after rPMS to trapezius muscles as assessed by the Migraine Disability Assessment (MIDAS) questionnaire 44 . Of note, the local pressure pain threshold (PPT) of the trapezius muscles was steadily increasing during the course of the six sessions of rPMS applied in this previous study, indicating local muscular effects besides alleviation of headache symptoms 44 . In another trial rPMS was administered either to the trapezius muscle (considered part of the TCC) or the deltoid muscle (considered not to be part of the TCC) to evaluate local effects and differences depending on the muscle stimulated 45 .…”

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confidence: 99%

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Alleviation of migraine symptoms by application of repetitive peripheral magnetic stimulation to myofascial trigger points of neck and shoulder muscles – A randomized trial

Renner

Sollmann

Heinen

et al. 2020

Sci Rep

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Migraine is a burdensome disease with an especially high prevalence in women between the age of 15 and 49 years. Non-pharmacological, non-invasive therapeutic methods to control symptoms are increasingly in demand to complement a multimodal intervention approach in migraine. Thirty-seven subjects (age: 25.0 ± 4.1 years; 36 females) diagnosed with high-frequency episodic migraine who presented at least one active myofascial trigger point (mTrP) in the trapezius muscles and at least one latent mTrP in the deltoid muscles bilaterally prospectively underwent six sessions of repetitive peripheral magnetic stimulation (rPMS) over two weeks. Patients were randomly assigned to receive rPMS applied to the mTrPs of the trapezius (n = 19) or deltoid muscles (n = 18). Whereas the trapezius muscle is supposed to be part of the trigemino-cervical complex (TCC) and, thus, involved in the pathophysiology of migraine, the deltoid muscle was not expected to interfere with the TCC and was therefore chosen as a control stimulation site. The headache calendar of the German Migraine and Headache Society (DMKG) as well as the Migraine Disability Assessment (MIDAS) questionnaire were used to evaluate stimulation-related effects. Frequency of headache days decreased significantly in both the trapezius and the deltoid group after six sessions of rPMS (trapezius group: p = 0.005; deltoid group: p = 0.003). The MIDAS score decreased significantly from 29 to 13 points (p = 0.0004) in the trapezius and from 31 to 15 points (p = 0.002) in the deltoid group. Thus, rPMS applied to mTrPs of neck and shoulder muscles offers a promising approach to alleviate headache frequency and symptom burden. Future clinical trials are needed to examine more profoundly these effects, preferably using a sham-controlled setting. According to the Global Burden of Disease Study more than one billion people were suffering from migraine in 2016, making migraine one of the most prevalent neurological disorders worldwide 1. Especially women between the age of 15 and 49 years are concerned-in this group migraine is also the first cause of disability worldwide 1-4. Further, migraineurs show a considerably reduced health-related quality of life (QoL) and considerable loss in work productivity 5-7. The high impact of migraine on QoL is reflected by percentages as high as 85%

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confidence: 59%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Alleviation of migraine symptoms by application of repetitive peripheral magnetic stimulation to myofascial trigger points of neck and shoulder muscles – A randomized trial

Renner

Sollmann

Heinen

et al. 2020

Sci Rep

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Children with migraine: Provocation of headache via pressure to myofascial trigger points in the trapezius muscle? – A prospective controlled observational study

Landgraf

Biebl

Langhagen

et al. 2017

European Journal of Pain

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A study of flex miniaturized coils for focal nerve magnetic stimulation

et al. 2022

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Background: Peripheral magnetic stimulation (PMS) is emerging as a complement to standard electrical stimulation (ES) of the peripheral nervous system (PNS). PMS may stimulate sensory and motor nerve fibers without the discomfort associated with the ES used for standard nerve conduction studies. The PMS coils are the same ones used in transcranial magnetic stimulation (TMS) and lack focality and selectiveness in the stimulation. Purpose: This study presents a novel coil for PMS, developed using Flexible technologies, and characterized by reduced dimensions for a precise and controlled targeting of peripheral nerves. Methods: We performed hybrid electromagnetic (EM) and electrophysiological simulations to study the EM exposure induced by a novel miniaturized coil (or mcoil) in and around the radial nerve of the neuro-functionalized virtual human body model Yoon-Sun, and to estimate the current threshold to induce magnetic stimulation (MS) of the radial nerve. Eleven healthy subjects were studied with the mcoil, which consisted of two 15 mm diameter coils in a figure-ofeight configuration, each with a hundred turns of a 25 µm copper-clad four-layer foil. Sensory nerve action potentials (SNAPs) were measured in each subject using two electrodes and compared with those obtained from standard ES. The SNAPs conduction velocities were estimated as a performance metric. Results: The induced electric field was estimated numerically to peak at a maximum intensity of 39 V/m underneath the mcoil fed by 70 A currents. In such conditions, the electrophysiological simulations suggested that the mcoil elicits SNAPs originating at 7 mm from the center of the mcoil. Furthermore, the numerically estimated latencies and waveforms agreed with those obtained during the PMS experiments on healthy subjects, confirming the ability of the mcoil to stimulate the radial nerve sensory fibers. Conclusion: Hybrid EM-electrophysiological simulations assisted the development of a miniaturized coil with a small diameter and a high number of turns using flexible electronics. The numerical dosimetric analysis predicted the threshold current amplitudes required for a suprathreshold peripheral nerve sensory stimulation, which was experimentally confirmed. The developed and now validated computational pipeline will be used to improve the performances (e.g., focality and minimal currents) of new generations of mcoil designs.

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Magnetic stimulation of the upper trapezius muscles in patients with migraine – A pilot study

Cited by 28 publications

References 37 publications

Alleviation of migraine symptoms by application of repetitive peripheral magnetic stimulation to myofascial trigger points of neck and shoulder muscles – A randomized trial

Alleviation of migraine symptoms by application of repetitive peripheral magnetic stimulation to myofascial trigger points of neck and shoulder muscles – A randomized trial

Children with migraine: Provocation of headache via pressure to myofascial trigger points in the trapezius muscle? – A prospective controlled observational study

A study of flex miniaturized coils for focal nerve magnetic stimulation

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