Transcranial direct current stimulation over the primary motor vs prefrontal cortex in refractory chronic migraine: A pilot randomized controlled trial

Andrade, Suellen Marinho; Aranha, Renata Emanuela Lyra de Brito; Oliveira, Eliane Araújo de; Mendonça, Camila Teresa Ponce Leon de; Martins, Wanessa Kallyne Nascimento; Torro-Alves, Nelson; Fernández‐Calvo, Bernardino

doi:10.1016/j.jns.2017.05.007

Cited by 63 publications

(91 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were a total of 34 studies included in the descriptive synthesis. Of those, 22 were TMS (16 rTMS) and 12 were tDCS articles (Supplementary Materials – Study Characteristics Tables). A comparison of defining study parameters is outlined below.…”

Section: Resultsmentioning

confidence: 99%

“…The remainder lower quality studies demonstrated many biases, including selection, performance, detection, attrition, and reporting bias (Table ). In regard to outcomes, most of the studies reported decreases in headache frequency and abortive medication use, excluding the Antal et al study which reported no change for frequency and Alhassani et al that showed no change for abortive medication use. Studies reporting on headache duration and intensity either decreased or had no reported change.…”

Section: Resultsmentioning

confidence: 99%

“…17,32 Various studies have been performed using tDCS for both episodic and chronic migraine, tension-type headache, and mixed headache. 10,[38][39][40][41][42][43][44][45][46][47] Anodal tDCS is the most commonly employed technique with the anode over M1 and the cathode over the contralateral supraorbital area using 1-2 mA current intensity for 15-20 minutes. See included studies section below for further description.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

et al. 2019

View full text Add to dashboard Cite

Background Headache is among the most prevalent causes of disability worldwide. Non‐pharmacologic interventions, including neuromodulation therapies, have been proposed in patients who are treatment resistant or intolerant to medications. Objective To perform a systematic review on the use of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) for the treatment of specific headache disorders (ie, migraine, tension, cluster, posttraumatic). Methods Data sources: Ovid MEDLINE, Cochrane Central Register of Clinical Trials, Embase, Scopus, PsycINFO. Data extraction: All references were reviewed by 2 independent researchers (3039 abstracts, duplicates removed). Records were selected by inclusion criteria for participants (adults 18‐65 with primary or secondary headaches), interventions (TMS and tDCS applied as headache treatment), comparators (sham or alternative standard of care), and study type (cohort, case‐control, and randomized controlled trials [RCT]). Studies were assessed using the Cochrane Risk of Bias Tool and overall quality determined through the GRADE Tool. A structured synthesis was performed due to heterogeneity of participants and methods. Results Thirty‐four studies were included: 16 rTMS, 6 TMS (excluding rTMS), and 12 tDCS. The majority investigated treatment for migraine (19/22 TMS, 8/12 tDCS). Quality of evidence ranged from very low to high. Conclusion Of all TMS and tDCS modalities, rTMS is most promising with moderate evidence that it contributes to reductions in headache frequency, duration, intensity, abortive medication use, depression, and functional impairment. However, only few studies reported changes greater than sham treatment. Further high‐quality RCTs with standardized protocols are required for each specific headache disorder to validate a treatment effect. Registration Number: PROSPERO 2017 CRD42017076232.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Andrade et al 43 directly compared the effects of tDCS to the M1 with that to the DLPFC, with a reported improved effect associated with DLPFC stimulation. Andrade et al 43 directly compared the effects of tDCS to the M1 with that to the DLPFC, with a reported improved effect associated with DLPFC stimulation.…”

Section: Discussionmentioning

confidence: 99%

Effects of Non‐invasive Brain Stimulation on Headache Intensity and Frequency of Headache Attacks in Patients With Migraine: A Systematic Review and Meta‐Analysis

Feng

Zhang

et al. 2019

Headache

View full text Add to dashboard Cite

Background Non‐invasive brain stimulation (NIBS) techniques such as repetitive transcranial magnetic stimulation (rTMS), as well as transcranial direct current stimulation (tDCS) electrically stimulate the brain and modify brain activity to suppress pain. This method is emerging as a potential clinical intervention against migraine. Objective To quantitatively review the efficacy of rTMS and tDCS in randomized controlled trials (RCTs) in modifying headache intensity and frequency of headache attacks in patients suffering from migraine. Methods We searched 5 databases: PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus for articles from January 2000 to September 2018. Any RCT regarding the efficacy on rTMS and tDCS on patients with migraine, was considered to be included. A random effects meta‐analysis was performed to pool effect sizes of outcomes related to headache intensity or frequency of headache attacks. The methodological quality of the included RCTs was assessed using the Physiotherapy Evidence Database scale. Results Nine RCTs with 276 participants in total (experimental group [EG] = 149; control group [CG] = 127) were included in this review. Five included articles used rTMS (EG = 81; CG = 80), and 4 used tDCS (EG = 68; CG = 47). Meta‐analysis of excitatory primary motor cortex (M1) stimulation showed significant effects on reducing headache intensity in patients with migraine (Hedges' g = −0.94; 95% CI, −1.28 to −0.59; P < .001, I2 = 18.39%) with a large effect size. Meta‐analysis of excitatory M1 stimulation showed significant effects on reducing frequency of headache attacks in patients with migraine, with a large effect size (Hedges' g = −0.88; 95% CI, −1.38 to −0.38; P = .001, I2 = 57.15%). Excitatory dorsolateral prefrontal cortex stimulation showed a significant effect on the headache intensity in patients with migraine (Hedges' g = −1.14; 95% CI, −2.21 to −0.07; P = .04, I2 = 61.86%) with a large effect size. However, reductions of frequency of headache attacks was not significant. Limitations Potential differential effects of rTMS and tDCS, various sham methods, and potential overlapping headache disorders among included subjects may affect the estimation of effect sizes. Conclusion Excitatory NIBS of the M1 is likely to reduce headache intensity and the frequency of headache attacks in patients with migraine.

show abstract

“…A number of tDCS studies in different pain disorders [16, 17] have demonstrated that tDCS is well-tolerated by patients [18]. Anodal tDCS proved effective over either the motor cortex or the dorsolateral prefrontal cortex when used as prophylactic strategy both in episodic [19] and chronic [20, 21] migraine. Moreover, some studies reported that, in addition to the therapeutic effects, tDCS over the visual cortex also normalized interictal cortical hyperresponsivity in episodic migraine [22].…”

Section: Introductionmentioning

confidence: 99%

Anodal transcranial direct current stimulation over the left temporal pole restores normal visual evoked potential habituation in interictal migraineurs

et al. 2017

View full text Add to dashboard Cite

BackgroundNeuroimaging data has implicated the temporal pole (TP) in migraine pathophysiology; the density and functional activity of the TP were reported to fluctuate in accordance with the migraine cycle. Yet, the exact link between TP morpho-functional abnormalities and migraine is unknown. Here, we examined whether non-invasive anodal transcranial direct current stimulation (tDCS) ameliorates abnormal interictal multimodal sensory processing in patients with migraine.MethodsWe examined the habituation of visual evoked potentials and median nerve somatosensory evoked potentials (SSEP) before and immediately after 20-min anodal tDCS (2 mA) or sham stimulation delivered over the left TP in interictal migraineurs.ResultsPrior to tDCS, interictal migraineurs did not exhibit habituation in response to repetitive visual or somatosensory stimulation. After anodal tDCS but not sham stimulation, migraineurs exhibited normal habituation responses to visual stimulation; however, tDCS had no effect on SSEP habituation in migraineurs.ConclusionOur study shows for the first time that enhancing excitability of the TP with anodal tDCS normalizes abnormal interictal visual information processing in migraineurs. This finding has implications for the role of the TP in migraine, and specifically highlights the ventral stream of the visual pathway as a pathophysiological neural substrate for abnormal visual processing in migraine.

show abstract

Transcranial direct current stimulation over the primary motor vs prefrontal cortex in refractory chronic migraine: A pilot randomized controlled trial

Cited by 63 publications

References 86 publications

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

Effects of Non‐invasive Brain Stimulation on Headache Intensity and Frequency of Headache Attacks in Patients With Migraine: A Systematic Review and Meta‐Analysis

Anodal transcranial direct current stimulation over the left temporal pole restores normal visual evoked potential habituation in interictal migraineurs

Contact Info

Product

Resources

About