The efficacy of repetitive transcranial magnetic stimulation in treating patients with chronic daily headache

Abstract

Background Headache is the most common pain disorder, affecting around 66% of the global population. This study aimed to investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating patients with primary chronic daily headaches (chronic tension-type headache and chronic migraine). Methods Twenty-seven patients participated in the study, divided into 2 groups: a study group (16 patients) and a control group (11 patients). Treatment consisted of 12 high-frequency (5 Hz) real rTMS sessions, delivered over the left dorsolateral prefrontal cortex (DLPFC), whereas sham rTMS was used for the control group. Results Patients of the study group, after real rTMS stimulation, showed a high statistically significant reduction of the measured headache parameters compared to the control group (P value < 0.001), and the percentage of improvement was 94.5%. No significant reduction of headache parameters, after sham rTMS stimulation, was observed in the control group (P value > 0.05) and the percentage of improvement was 7.9%. Conclusion High-frequency rTMS is effective in reducing chronic tension headaches and chronic migraines. This finding runs with the approval of the suggested role of DLPFC in pain control. This might open opinions for new treatment strategies in tension-type headache and migraine prevention.

Effectiveness of High-Frequency Repetitive Transcranial Magnetic Stimulation in Migraine

“…All but one study included patients with chronic migraine only. The study by AbdElkader et al 26 included patients with chronic daily headaches together with migraine. All eight RCTs have concluded that rTMS is effective treatment approach for migraine.…”

“…The inclusion criteria were similar for all the studies with greater diversity in exclusion criteria especially concerning the presence of depression. Of the included studies, three have explicitly excluded patients with depression 26,27,29 and one study has reported absence of patients with clinical depression 28 . In addition, three RCTs have excluded patients with severe psychiatric comorbidity 31–33 .…”