Tracking tDCS induced grey matter changes in episodic migraine: a randomized controlled trial

Abstract

Background Occipital transcranial direct current stimulation (tDCS) is an effective and safe treatment for migraine attack prevention. Structural brain alterations have been found in migraineurs in regions related to pain modulation and perception, including occipital areas. However, whether these structural alterations can be dynamically modulated through tDCS treatment is understudied. Objective To track longitudinally grey matter volume changes in occipital areas in episodic migraineurs during and up to five months after occipital tDCS treatment in a single-blind, and sham-controlled study. Methods 24 episodic migraineurs were randomized to either receive verum or sham occipital tDCS treatment for 28 days. To investigate dynamic grey matter volume changes patients underwent structural MRI at baseline (prior to treatment), 1.5 months and 5.5 months (after completion of treatment). 31 healthy controls were scanned with the same MRI protocol. Morphometry measures assessed rate of changes over time and between groups by means of tensor-based morphometry. Results Before treatment, migraineurs reported 5.6 monthly migraine days on average. A cross-sectional analysis revealed grey matter volume increases in the left lingual gyrus in migraineurs compared to controls. Four weeks of tDCS application led to a reduction of 1.9 migraine days/month and was paralleled by grey matter volume decreases in the left lingual gyrus in the treatment group; its extent overlapping with that seen at baseline. Conclusion This study shows that migraineurs have increased grey matter volume in the lingual gyrus, which can be modified by tDCS. Tracking structural plasticity in migraineurs provides a potential neuroimaging biomarker for treatment monitoring. Trial registration ClinicalTrials.gov, NCT03237754. Registered 03 August 2017 – retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03237754.

Imaging the brain and vascular reactions to headache treatments: a systematic review

“…Only one study [ 74 ] has explored structural brain changes after transcranial direct current stimulation (tDCS), examining 24 patients with migraine who received tDCS or sham stimulation over the visual cortex for 28 days. Compared to sham stimulation, in patients treated with tDCS the frequency of monthly migraine days progressively decreased during the four months after treatment initiation and returned to baseline during the fifth month [ 75 ].…”

“…Another non-invasive neuromodulation method is the tDCS, which modulates the cortical activity by applying an excitatory or inhibitory electric current to the scalp [ 102 ]. Only two studies [ 73 , 74 ] have investigated functional and structural brain changes related to rTMS and tDCS treatments. The small sample size of these studies, the lack of a control group and the use of an uncorrected statistical threshold disallow solid conclusions regarding central modifications related to these treatments.…”

Non-invasive Brain Stimulation for Chronic Pain: State of the Art and Future Directions

“…Over the past 20 years, the number of studies that used NIBS techniques for pain treatment has exponentially grown, a trend that possibly reflects the importance of this field ( Figure 2 and Table 1 ). Thus far, NIBS has been applied to manage various CP conditions, including fibromyalgia ( Forogh et al, 2021 ), neuropathic pain (NP) ( Galhardoni et al, 2019 ), and migraine ( Schading et al, 2021 ). Although the neural mechanisms underlying the analgesic effects of NIBS are not yet fully understood, the mechanisms behind the functional effects of each NIBS technique are different ( Leocani et al, 2019 ).…”

Treatment with morning blue light increases left amygdala volume and sleep duration among individuals with posttraumatic stress disorder

“…Decreased volume of the amygdala appears to be a particularly common finding, but there is uncertainty as to whether this represents a stable pre-existing risk factor for PTSD or if volume reductions emerge as a result of the stress response to trauma. Moreover, there is ample evidence to suggest that GMV is somewhat plastic and can be modified with experience ( Ditye et al, 2013 ; Sun et al, 2016 ; Wenger et al, 2017 , 2021 ; Ueno et al, 2018 ) or treatment ( Perini et al, 2017 ; Butler et al, 2018 ; Mancke et al, 2018 ; Husain et al, 2019 ; Wang et al, 2019 ; Brancati et al, 2021 ; Schading et al, 2021 ; Soshi et al, 2021 ; Yang et al, 2021 ). Nevertheless, there has been relatively little research examining longitudinal changes in GMV over a course of treatment or with measured changes in relevant PTSD symptoms.…”