Long-Term Effects of Self-Administered Transcranial Direct Current Stimulation in Episodic Migraine Prevention: Results of a Randomized Controlled Trial.
Hyperexcitability; migraine; migraine days; neuromodulation; neurostimulation; tDCS; Adolescent; Adult; Aged; Aged, 80 and over; Double-Blind Method; Electrodes; Humans; Middle Aged; Single-Blind Method; Young Adult; Migraine Disorders/therapy; Transcranial Direct Current Stimulation; Migraine Disorders; Neurology; Neurology (clinical); Anesthesiology and Pain Medicine; General Medicine
Abstract :
[en] ("[en] BACKGROUND: Migraine is a multifactorial neurovascular disorder, which affects about 12% of the general population. In episodic migraine, the visual cortex revealed abnormal processing, most likely due to decreased preactivation level. Transcranial direct current stimulation (tDCS) is able to modify cortical excitability and might result in an alleviation of migraine occurrence if used repetitively.
OBJECTIVE: To test the hypothesis that self-administered anodal tDCS over the visual cortex significantly decreases the number of monthly migraine days in episodic migraine.
MATERIALS AND METHODS: The study was single-blind, randomized, and sham-controlled. Inclusion criteria were age 18-80 years and an ICHD-3 diagnosis of episodic migraine. Exclusion criteria were pregnancy, presence of a neurodegenerative disorder, a contraindication against MRI examinations, and less than two migraine days during the 28-day baseline period. Patients in whom the baseline period suggested chronic migraine were excluded. After baseline, participants applied daily either verum (anodal-1 mA to 20 min) or sham tDCS (anodal-1 mA to 30 sec) at Oz (reference Cz electrode) for 28 days. Headache diaries were used to record the number of migraine days at baseline, during the stimulation period, and during four subsequent 28-day periods.
RESULTS: Twenty-eight patients were included; two were excluded after the baseline period because less than two migraine days occurred; three were excluded because their headache diaries suggested the diagnosis of chronic migraine. Twenty-three datasets were taken for further analysis. Compared to sham tDCS (n = 12), verum tDCS (n = 11) resulted in a lower number of migraine days (p = 0.010) across all follow-up periods. We found no significant change in total headache days (p = 0.165), anxiety (p = 0.884), or depression scores (p = 0.535). No serious adverse events occurred; minor side effects were similar in both groups.
CONCLUSIONS: This study provides Class II evidence that self-administered anodal tDCS over the visual cortex in episodic migraine results in a significantly lower number of monthly migraine days. However, it has neither an immediate nor a long-term effect.","[en] ","")
Disciplines :
Neurology
Author, co-author :
Pohl, Heiko ; Department of Neurology, University Hospital Zurich, Zurich, Switzerland
Moisa, Marius ; Zurich Center for Neuroeconomics (ZNE), Department of Economics, University of Zurich, Zurich, Switzerland
Jung, Hans-H; Department of Neurology, University Hospital Zurich, Zurich, Switzerland
Brenner, Kathrin; Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
Aschmann, Jessica; Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
Riederer, Franz ; Department of Neurology, University Hospital Zurich, Zurich, Switzerland ; Neurological Center Rosenhügel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria
Ruff, Christian C ; Zurich Center for Neuroeconomics (ZNE), Department of Economics, University of Zurich, Zurich, Switzerland
Schoenen, Jean ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie (CHR)
Luechinger, Roger ; Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland
Widmer, Lukas; Department of Neurology, University Hospital Zurich, Zurich, Switzerland
Petersen, Jens A ; Neurozentrum Bern, Bern, Switzerland
Gantenbein, Andreas R; Department of Neurology, University Hospital Zurich, Zurich, Switzerland ; RehaClinic Bad Zurzach, Bad Zurzach, Switzerland
Sandor, Peter S; Department of Neurology, University Hospital Zurich, Zurich, Switzerland ; RehaClinic Bad Zurzach, Bad Zurzach, Switzerland
Michels, Lars ; Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
Long-Term Effects of Self-Administered Transcranial Direct Current Stimulation in Episodic Migraine Prevention: Results of a Randomized Controlled Trial.
ERC - European Research Council [BE] SNF - Schweizerische Nationalfonds zur Förderung der wissenschaftlichen Forschung [CH]
Funding text :
Source(s) of financial support: Heiko Pohl was funded by the Werner Dessauer Stiftung. Christian C. Ruff received support from the SNSF (grant no. 100019L_173248) and from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement No 725355, BRAINCODES).
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