Non-invasive Brain Stimulation in Pediatric Migraine: A Perspective From Evidence in Adult Migraine

Abstract

Pediatric migraine remains still a challenge for the headache specialists as concerns both diagnostic and therapeutic aspects. The less ability of children to describe the exact features of their migraines and the lack of reliable biomarker for migraine contribute to complicate the diagnostic process. Therefore, there's need for new effective tools for supporting diagnostic and therapeutic approach in children with migraine. Recently, promising results have been obtained in adult headache by means of application of neurostimulation techniques both for investigating pathophysiological mechanisms and also for therapeutical applications. Non-invasive brain stimulation (NIBS) techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) indeed proved to be generally safe and showing also some evidence of efficacy particularly for the symptomatic treatment. On such basis, in the last years increasing interest is rising in scientific pediatric community to evaluate the potential of such approaches for treatment pediatric headaches, particularly in migraine, even if the evidence provided is still very poor. Here we present a perspective for application of TMS and tDCS technique in children migraine principally based on evidence coming by studies in adults.

Transcranial Direct Current Stimulation in Treatment of Child Neuropsychiatric Disorders: Ethical Considerations

“…No serious side effects were reported. These effects are important in the context of the pediatric population (Brighina et al, 2019).…”

Deriving mechanistic insights from machine learning and its possible implications in non-invasive brain stimulation research

“…In recent years, non-invasive brain stimulation has evolved not only as an effective research tool but also as a promising treatment modality for neuropsychiatric disorders. There is mounting evidence from large multicentric trials showcasing the therapeutic potential of repetitive transcranial magnetic stimulation in major depressive disorder [1], obsessive compulsive disorder [2], migraine [3] and substance use disorders [4]. More trials are underway to study the effectiveness of non-invasive brain stimulation protocols in the treatment of schizophrenia, epilepsy, movement disorders and in stroke rehabilitation [5e8].…”

Response Predictors of Repetitive Neuromuscular Magnetic Stimulation in the Preventive Treatment of Episodic Migraine

“…Medication for migraine attacks is well-established and widely used; yet, responsiveness to prophylactic treatment varies and treatment adherence is often poor (e.g., due to side effects or insufficient adjustment of dosage) (7,8). Against this background, innovative non-pharmacological treatment options are highly required (4,(8)(9)(10).…”