Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine
| Autor: | Clara C. F. B. Kirschner, Mario Fernando Prieto Peres, André Leite Gonçalves, Vera Z. Guendler, Josione Rêgo Ferreira, Juliane Prieto Peres Mercante, Adriana Bastos Conforto, Edson Amaro |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Migraine Disorders medicine.medical_treatment Prefrontal Cortex Placebo behavioral disciplines and activities Chronic Migraine Double-Blind Method mental disorders medicine Humans Effective treatment In patient Depression (differential diagnoses) business.industry General Medicine Transcranial Magnetic Stimulation Clinical trial Transcranial magnetic stimulation Dorsolateral prefrontal cortex Treatment Outcome medicine.anatomical_structure nervous system Anesthesia Feasibility Studies Female Neurology (clinical) business psychological phenomena and processes |
| Zdroj: | Cephalalgia. 34:464-472 |
| ISSN: | 1468-2982 0333-1024 |
| DOI: | 10.1177/0333102413515340 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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