TRANSCUTANEOUS OCCIPITAL NERVE STIMULATION AND TRANSCRANIAL DIRECT CURRENT STIMULATION IN CHRONIC MIGRAINE: A PILOT COMPARISON OF THERAPEUTIC AND ELECTROPHYSIOLOGICAL EFFECTS
[en] Background: Management of chronic migraine (CM) is
often challenging. There is a need for more effective and
better-tolerated preventive therapies. Among non-invasive
neurostimulation procedures, transcutaneous occipital
nerve stimulation (tONS) would act via central pain modulation,
while transcranial direct current stimulation
(tDCS) would modify cortical excitability that is abnormal
in CM.
Objectives: In this pilot trial we compared the clinical
effects of tDCS and tONS in refractory CM and their
ability to modify nociception and cortical responsiveness.
Methods: Forty-three CM patients (17 with history of
drug overuse) applied either 2mA tDCS during 2 months (N¼20, cathode over visual cortex, anode over left
DLPFC), or tONS during 3 months (N¼23, Cefaly Kit
ArnoldTM), both in daily 20 min-sessions. Visual evoked
potentials (VEP), nociceptive blink reflexes (nBR) and
quantitative sensory testing were recorded before and
after treatment.
Results: During the last stimulation month, total headache
days decreased in both groups ( 16.4% for tDCS,
17% for tONS, p<0.05). Migraine days were reduced by
21.4% (p¼0.06) and 22% (p<0.05) respectively, while
30% responder rates were 47% and 42%. Medication
intake was significantly reduced after tONS ( 43%).
There was no significant change of nBR in either group.
VEP habituation reversed to an episodic migraine pattern,
i.e. a deficit, after tONS but not after tDCS.
Conclusion: tONS and inhibitory tDCS of the visual
cortex are interesting non-invasive options for the treatment
of CM, but these results have to be confirmed in a
randomized controlled trial. tONS was able to induce
recordable changes in visual cortex responsiveness
Disciplines :
Neurology
Author, co-author :
MAGIS, Delphine ; Centre Hospitalier Universitaire de Liège - CHU > Service de neurologie (CHR)
D'Ostilio, Kevin ; Université de Liège > Département des sciences biomédicales et précliniques > Neuro-anatomie
Baschi
Cosseddu, Anna
Lisicki Martinez, Marco ; Université de Liège > Département des sciences cliniques > Département des sciences cliniques
NONIS, Romain ; Centre Hospitalier Universitaire de Liège - CHU > Service d'urologie
Simona, Sava
SCHOENEN, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Service de neurologie (CHR)
Language :
English
Title :
TRANSCUTANEOUS OCCIPITAL NERVE STIMULATION AND TRANSCRANIAL DIRECT CURRENT STIMULATION IN CHRONIC MIGRAINE: A PILOT COMPARISON OF THERAPEUTIC AND ELECTROPHYSIOLOGICAL EFFECTS
Publication date :
2016
Journal title :
Cephalalgia
ISSN :
0333-1024
eISSN :
1468-2982
Publisher :
Blackwell Science, Osney Mead Oxford, United Kingdom
Volume :
36
Issue :
1S
Pages :
31
Peer reviewed :
Peer Reviewed verified by ORBi
European Projects :
FP7 - 602633 - EUROHEADPAIN - Mechanisms and Treatment of Migraine and its Chronification