Efficacy of Noninvasive Brain Stimulation on Pain Control in Migraine Patients: A Systematic Review and Meta‐Analysis

Shirahige, Lívia; Melo, Lorena; Nogueira, Fernanda; Rocha, Sérgio; Monte-Silva, Kátia

doi:10.1111/head.12981

Cited by 59 publications

(59 citation statements)

References 37 publications

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“…For example, there is good evidence that EBS is effective in major depression [15], but not fibromyalgia pain [16], food craving and consumption [17], Parkinson’s disease [18] and stroke aphasia [19]. A common finding from these meta-analyses is that EBS studies are often of low research quality [20, 21] and that, when present, EBS effects are often small [20–24]. For example, EBS reduces chronic pain by only 12% (95% CI 8% to 15%), below the threshold for a minimal clinically important difference [22], and anodal EBS is associated with a significant reduction in reaction time, but the magnitude of this effect is small (Hedges’ g: −0.10, 95% CI −0.16 to −0.04) [24].…”

Section: Discussionmentioning

confidence: 99%

Questionable science and reproducibility in electrical brain stimulation research

Héroux¹,

Loo²,

Taylor³

et al. 2017

PLoS ONE

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Electrical brain stimulation (EBS) is a trendy new technique used to change brain function and treat neurological, psychiatric and psychological disorders. We were curious whether the published literature, which is dominated by positive results, reflects the experience of researchers using EBS. Specifically, we wanted to know whether researchers are able to reproduce published EBS effects and whether they engage in, but fail to report, questionable research practices. We invited 976 researchers to complete an online survey. We also audited 100 randomly-selected published EBS papers. A total of 154 researchers completed the survey. Survey respondents had a median of 3 [1 to 6, IQR] published EBS papers (1180 total) and 2 [1 to 3] unpublished ones (380 total). With anodal and cathodal EBS, the two most widely used techniques, 45–50% of researchers reported being able to routinely reproduce published results. When asked about how study sample size was determined, 69% of respondents reported using the sample size of published studies, while 61% had used power calculations, and 32% had based their decision on pilot data. In contrast, our audit found only 6 papers where power calculations were used and a single paper in which pilot data was used. When asked about questionable research practices, survey respondents were aware of other researchers who selectively reported study outcomes (41%) and experimental conditions (36%), adjusted statistical analysis to optimise results (43%), and engaged in other shady practices (20%). Fewer respondents admitted to engaging in these practices themselves, although 25% admitted to adjusting statistical analysis to optimize results. There was strong agreement that such practices should be reported in research papers; however, our audit found only two such admissions. The present survey confirms that questionable research practices and poor reproducibility are present in EBS studies. The belief that EBS is effective needs to be replaced by a more rigorous approach so that reproducible brain stimulation methods can be devised and applied.

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Section: Discussionmentioning

confidence: 99%

Questionable science and reproducibility in electrical brain stimulation research

Héroux¹,

Loo²,

Taylor³

et al. 2017

PLoS ONE

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“…tDCS, using a portable, hand‐held device, can modulate pain‐related neural networks . It has also been shown to cause reduction of analgesic drug intake with pain, and has minimal adverse events …”

Section: Emerging Noninvasive Neuromodulation For Migraine Preventionmentioning

confidence: 99%

“…20 It has also been shown to cause reduction of analgesic drug intake with pain, and has minimal adverse events. 21,22 Fifty adult women with migraine with or without aura who were refractory to pharmacological therapy were enrolled to either continue to receive their current pharmacological treatment vs augment current treatment with tDCS. 23 Thirty subjects received 10 procedures of tDCS over 30 days, with each treatment stimulation being given over M1 of the subject's dominant hemisphere for 20 minutes.…”

Section: Emerging Noninvasive Neuromodulation For Mig Raine Preventionmentioning

confidence: 99%

Neuromodulation for the Acute and Preventive Therapy of Migraine and Cluster Headache

2019

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Headache disorders are among the most common and disabling medical conditions worldwide. Pharmacologic acute and preventive treatments are often insufficient and poorly tolerated, and the majority of patients are unable to adhere to their migraine treatments due to these issues. With improvements in our understanding of migraine and cluster headache pathophysiology, neuromodulation devices have been developed as safe and effective acute and preventive treatment options. In this review, we focus on neuromodulation devices that have been studied for migraine and cluster headache, with special attention to those that have gained food and drug administration (FDA) clearance. We will also explore how these devices can be used in patients who might have limited pharmacologic options, including the elderly, children, and pregnant women.

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“…Few data are available from randomized sham-controlled studies to evaluate the efficacy of tDCS devices; however, subgroup analysis from a recent meta-analysis of noninvasive brain stimulation found moderate quality evidence suggesting that tDCS reduced pain intensity, number of migraines, and "painkiller" intake. 22 The Cefaly device has been shown in RCTs to be of benefit for both abortive and preventive therapy and is FDA approved for the prevention of episodic migraine. The gammaCore device (a peripheral vagal nerve stimulator) has shown efficacy in RCTs as an acute treatment for episodic and chronic migraines.…”

Section: New Developments In Established Migraine Treatmentsmentioning

confidence: 99%

Migraine Headache: Updates and Future Developments

Bohm

Stancampiano

Rozen

2018

Mayo Clinic Proceedings

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Efficacy of Noninvasive Brain Stimulation on Pain Control in Migraine Patients: A Systematic Review and Meta‐Analysis

Cited by 59 publications

References 37 publications

Questionable science and reproducibility in electrical brain stimulation research

Questionable science and reproducibility in electrical brain stimulation research

Neuromodulation for the Acute and Preventive Therapy of Migraine and Cluster Headache

Migraine Headache: Updates and Future Developments

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