Journal: Neuroscience Letters 623:7-12 (2016)
Authors: C Rapinesi, A Del Casale, P Scatena, G.D Kotzalidis, S Di Pietro, V.R Ferri, F.S Bersani, R Brugnoli, R.N Raccah, A Zangen, S Ferracuti, F Orzi, P Girardi, G Sette
Deep Transcranial Magnetic Stimulation (Deep TMS™) can be an alternative treatment to relieve pain in chronic migraine (CM).
The aim of this study was to evaluate the effect of high-frequency Deep TMS in add-on to standard treatment for CM in patients not responding to effective abortive or preventive drug treatment.
Forteen patients with International Classification of Headache Disorders, 3rdEdition (ICHD-3) treatment-resistant CM were randomized to add-on Deep TMS (n=7) or standard abortive or preventive antimigraine treatment (n=7). Three sessions of alternate day 10 Hz Deep TMS consisting of 600 pulses in 10 trains were delivered to the dorsolateral prefrontal cortex (DLPFC), bilaterally, but with left hemisphere prevalence, for 12 sessions spread over one month.
The add-on Deep TMS treatment was well-tolerated. Patients treated with Deep TMS showed significant reduction of pain intensity, frequency of attacks, analgesic overuse, and depressive symptoms during treatment and one month later, compared to the month preceding treatment and at the same time-points compared to the control group.
As compared to standard pharmacological treatment alone, add-on high-frequency Deep TMS of the bilateral DLPFC reduced the frequency and intensity of migraine attack, drug overuse, and depressive symptoms. This study supports the add-on Deep TMS treatment in treatment-resistant CM.
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