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Anodal transcranial direct current stimulation in chronic migraine and medication overuse headache: A pilot double-blind randomized sham-controlled trial
Institution:1. Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy;2. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy;3. Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy;4. Stroke Unit, IRCCS Mondino Foundation, Pavia, Italy;5. Neurology and Stroke Unit, Circolo Hospital and Macchi Foundation, Varese, Italy;6. DMC Department, Insubria University, Varese, Italy
Abstract:ObjectivesLittle evidence is available on the role of transcranial direct current stimulation (tDCS) in patients affected by chronic migraine (CM) and medication overuse headache (MOH). We aim to investigate the effects of tDCS in patients with CM and MOH as well as its role on brain activity.MethodsTwenty patients with CM and MOH were hospitalized for a 7-day detoxification treatment. Upon admission, patients were randomly assigned to anodal tDCS or sham stimulation delivered over the primary motor cortex contralateral to the prevalent migraine pain side every day for 5 days. Clinical data were recorded at baseline (T0), after 1 month (T2) and 6 months (T3). EEG recording was performed at T0, at the end of the tDCS/Sham treatment, and at T2.ResultsAt T2 and T3, we found a significant reduction in monthly migraine days (p = 0.001), which were more pronounced in the tDCS group when compared to the sham group (p = 0.016).At T2, we found a significant increase of alpha rhythm in occipital leads, which was significantly higher in tDCS group when compared to sham group.ConclusionstDCS showed adjuvant effects to detoxification in the management of patients with CM and MOH. The EEG recording showed a significant potentiation of alpha rhythm, which may represent a correlate of the underlying changes in cortico-thalamic connections.SignificanceThis study suggests a possible role for tDCS in the treatment of CM and MOH. The observed clinical improvement is coupled with a potentiation of EEG alpha rhythm.
Keywords:Neuromodulation  Transcranial direct current stimulation  Chronic Migraine  Medication overuse headache  Electroencephalography  CM"}  {"#name":"keyword"  "$":{"id":"k0035"}  "$$":[{"#name":"text"  "_":"chronic migraine  MOH"}  {"#name":"keyword"  "$":{"id":"k0045"}  "$$":[{"#name":"text"  "_":"medication overuse headache  ICHD-III"}  {"#name":"keyword"  "$":{"id":"k0055"}  "$$":[{"#name":"text"  "_":"International Classification of Headache Disorders – Third Edition  tDCS"}  {"#name":"keyword"  "$":{"id":"k0065"}  "$$":[{"#name":"text"  "_":"transcranial direct current stimulation  M1"}  {"#name":"keyword"  "$":{"id":"k0075"}  "$$":[{"#name":"text"  "_":"primary motor cortex  EEG"}  {"#name":"keyword"  "$":{"id":"k0085"}  "$$":[{"#name":"text"  "_":"electroencephalography  MIDAS"}  {"#name":"keyword"  "$":{"id":"k0095"}  "$$":[{"#name":"text"  "_":"Migraine Disability Assessment  HIT-6"}  {"#name":"keyword"  "$":{"id":"k0105"}  "$$":[{"#name":"text"  "_":"Headache Impact Test–6  VAS"}  {"#name":"keyword"  "$":{"id":"k0115"}  "$$":[{"#name":"text"  "_":"Visual Analogue Scale  MSQ"}  {"#name":"keyword"  "$":{"id":"k0125"}  "$$":[{"#name":"text"  "_":"Migraine-Specific Quality-of-Life Questionnaire  SF-36"}  {"#name":"keyword"  "$":{"id":"k0135"}  "$$":[{"#name":"text"  "_":"Short Form Health Survey  SCI"}  {"#name":"keyword"  "$":{"id":"k0145"}  "$$":[{"#name":"text"  "_":"Sleep Condition Indicator  PSQI"}  {"#name":"keyword"  "$":{"id":"k0155"}  "$$":[{"#name":"text"  "_":"Pittsburgh Sleep Quality Index  SDMT"}  {"#name":"keyword"  "$":{"id":"k0165"}  "$$":[{"#name":"text"  "_":"Symbol Digit Modalities Test
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