Effectiveness of cathodal tDCS of the primary motor or sensory cortex in migraine: A randomized controlled trial

Abstract

Objectives: Transcranial Direct Current Stimulation (tDCS) is a new technology that is extensively used for migraine treatment. The present study aims to examine the effectiveness of cathodal-tDCS (c-tDCS) in decreasing migraine pain frequency, duration, and intensity at the right primary motor cortex (M 1) or sensory cortex (S 1) in individuals with episodic or chronic migraine. Methods: The present study has a randomized, single-blind, and sham-controlled design. It tests the effectiveness of 22 sessions of c-tDCS (20min/1000 mA) in 45 migraine patients (episodic ¼ 35; chronic ¼ 10/with aura ¼ 28; without aura ¼ 17). Spread over 10 consecutive weeks, the sessions started with three sessions per week and ended with one session per week. Participants were tested at the baseline, at the end of intervention, and at 12-month follow-up. The migraine diagnosis was based on criteria set by International Headache Society (IHS) and patients were allocated to two experimental (n m1 ¼ 15; n s1 ¼ 15) and a sham intervention group (n c ¼ 15). Results: The results of a series of MANCOVAs showed a significant reduction (p < 0.05) in all hypothesized symptoms of migraine pain in both experimental groups compared to the sham intervention group at the posttest and follow-up. Conclusion: The application of c-tDCS to M 1 or S 1 can be used as a technological intervention for the prophylactic and therapeutic treatment of episodic or chronic migraine. Ethical committee registration number: Ir.mums.fm.rec.1396.362.

Neuromodulation techniques for acute and preventive migraine treatment: a systematic review and meta-analysis of randomized controlled trials

“…A low-quality study investigated anodal tDCS over the dominant M1 and was positive after 10 sessions applied over 30 days [ 51 ]. Another study was a moderate-quality trial comparing cathodal-tDCS over the right M1 or primary sensory cortex (S1) versus sham stimulation for 22 sessions spread over 10 consecutive weeks and was positive for the two active stimulation groups [ 52 ]. The difference was very large in both groups, with 12.47 days/month for the M1 and 9.47 for the S1 compared to sham.…”

Non-Invasive Neurostimulation Methods for Acute and Preventive Migraine Treatment—A Narrative Review

“…A further study compared cathodal tDCS over the right M1 area or the primary sensory cortex (S1) versus sham stimulation for 22 sessions over 10 consecutive weeks. The two active stimulation groups were effective [ 52 ]. The difference was very large in both groups, with 12.5 days/month for the M1 versus 9.5 for the S1 group compared to the sham group.…”

Is Allodynia a Determinant Factor in the Effectiveness of Transcranial Direct Current Stimulation in the Prophylaxis of Migraine?

“…In a meta‐analysis evaluating the tDCS protocols, it was noted that anodal M1 stimulation is more likely to reduce migraine attacks (29). Recently, Rahimi et al applied 22 sessions of cathodal M1 and S1 tDCS in 45 patients with chronic and episodic migraine and reported positive outcomes (73). The fact that anodal (both M1 and V1) tDCS is more effective than cathodal stimulation suggests that abnormal inhibitory circuits may be responsible for the pathophysiology of migraine.…”