Repetitive transcranial magnetic stimulation forprophylactive treatment of chronic migraine:A randomised, single-blind, parallel-group, shamcontrolled trial

[摘要] Background: Pilot studies suggest that repetitive transcranial magnetic stimulation could be effectivein migraine. We studied its efficacy for prophylaxis of chronic migraine. Methods: We undertook arandomised, single-blind, sham-controlled study in patients with chronic migraine. Subjects wererandomly allocated to sham, high-frequency repetitive transcranial magnetic stimulation (HF-rTMS)or low-frequency repetitive transcranial magnetic stimulation (LF-rTMS). The primary outcome wasthe reduction of attacks at four weeks. In addition, reduction of severity of headache based on theVisual Analogue Scale score at two & four weeks and a functional disability score at four weeks wasrecorded. Results: One hundred and eight patients were allocated to sham stimulation (n=36), HF-rTMS(n=36) and LF-rTMS (n=36) groups. The number of attacks per month decreased to 7.05+/-1.45 at fourweeks post-rTMS in the HF-rTMS (p<0.001) as compared to the LF-rTMS (10.61+/-1.69) and sham(10.83+/-3.37) groups. The VAS score in the HF-rTMS group was significantly lowered (p < 0.001)from 8.61+/-1.15 at baseline to 6.63+/-0.96, and 7.19+/-0.98 at two and four weeks respectively. Theduration of headache in hours over 4 weeks reduced from 32.4+/-14.9 to 11.6+/-6.14 in the HF-rTMSgroup (p<0.001), but did not change significantly in the LF-rTMS (30.4+/-11.9 to 27.8+/-14, p>0.05)and sham (26.8+/-11.06 to 37+/-15, p>0.05) in sham groups. There was no significant difference infunctional disability between all the study groups at four weeks.Conclusion: High-frequency, but not low-frequency, repetitive transcranial magnetic stimulation maybe useful in management of chronic migraine.

[学科分类] 精神健康和精神病学

[关键词] Repetitive transcranial magnetic stimulation (rTMS);migraine;sham;visual analogue scale