Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine

Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine

Author Conforto, Adriana B. Google Scholar
Amaro, Edson Google Scholar
Goncalves, Andre L. Google Scholar
Mercante, Juliane P. P. Google Scholar
Guendler, Vera Z. Google Scholar
Ferreira, Josione R. Google Scholar
Kirschner, Clara C. F. B. Google Scholar
Peres, Mario F. P. Autor UNIFESP Google Scholar
Institution Hosp Israelita Albert Einstein
Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Abstract Background High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (rTMS-DLPFC) is an effective treatment for depression. Preliminary studies indicated beneficial effects of rTMS-DLPFC on pain relief in patients treated for depression, and in patients with chronic migraine.Methods in this randomized, double-blind, parallel-group, single-center, proof-of-principle clinical trial, we tested the hypothesis that 23 sessions of active rTMS-DLPFC delivered over eight weeks would be feasible, safe and superior to sham rTMS to decrease the number of headache days in 18 patients with chronic migraine without severe depression. Per-protocol analysis was performed.Results rTMS-DLPFC applied over eight weeks was feasible and safe in patients with chronic migraine. Contrary to our primary hypothesis, the number of headache days decreased significantly more in the sham group than in the group treated with active rTMS-DLPFC at eight weeks. Average decrease in headache days was >50% in the sham group, indicating a powerful placebo response. Pain intensity improved in both groups to a similar extent.Conclusions Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.
Keywords Placebo
dorsolateral prefrontal cortex
transcranial magnetic stimulation
chronic migraine
pain
Language English
Sponsor Albert Einstein Israelite Hospital Teaching and Research Institute/Instituto de Ensino e Pesquisa do Hospital Israelita Albert Einstein
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number Albert Einstein Israelite Hospital Teaching and Research Institute/Instituto de Ensino e Pesquisa do Hospital Israelita Albert Einstein: IEP.PE.08-0122
CNPq: 472407/2007-4
Date 2014-05-01
Published in Cephalalgia. London: Sage Publications Ltd, v. 34, n. 6, p. 464-472, 2014.
ISSN 0333-1024 (Sherpa/Romeo, impact factor)
Publisher Sage Publications Ltd
Extent 464-472
Origin http://dx.doi.org/10.1177/0333102413515340
Access rights Closed access
Type Article
Web of Science ID WOS:000334157600009
URI http://repositorio.unifesp.br/handle/11600/37754

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account