Repetitive transcranial magnetic stimulation as a prophylactic treatment in migraine

Abstract

Background Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered. Objective To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A). Methods Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study. A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine. Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once. Results There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS (P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS (P < 0.001). Conclusion Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

“…A meta-analysis shows effectiveness of TMS in treating migraine with aura [34]. Prophylactic inhibitory rTMS at vertex in patients with known migraine regardless of the presence of aura apparently also reduces migraine median frequency by 12 days per month and median intensity by 6 points [35].…”

Clinical Research Progress on Physical Rehabilitation Therapy for Migraine

“…Magnetic signals can penetrate the skull and stimulate the brain nerves without attenuation [4] . Azza et al purposefully evaluated the preventive therapeutic effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on migraine (with and without aura) and its correlation with the level of serum inflammatory biomarkers (neurokinin A) [5] . The study found that the pain intensity, attack frequency, attack duration and migraine disability score of patients with migraine were significantly reduced after transcranial magnetic stimulation treatment, and the patient's serum neurokinin A level was also significantly reduced.…”