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Efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (rTMS) for migraine: a meta-analysis of randomized controlled trials

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Abstract

Objective

To assess the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation in the prevention or treatment of migraine by conducting a pooled analysis of relevant randomized controlled trials.

Methods

The PubMed, Embase, Cochrane, OVID, SCOPUS, Web of Science, and clinicaltrials.gov databases were systematically searched for randomized controlled trials (RCTs) comparing high-frequency rTMS and sham stimulation for the prevention or treatment of migraine. A meta-analysis of relevant outcome measures was performed using RevMan 5.3 software.

Results

Eight RCTs with a total of 384 patients were included. A total of 23 patients dropped out, and thus, 361 patients were ultimately included for analysis. The high-frequency rTMS group had a lower frequency of attacks than the sham group (MD = − 5.10; 95% CI: − 8.10, − 2.09; P = 0.0009). The rTMS group has less intense headaches than the sham group (SMD = − 0.74; 95% CI − 1.04, − 0.44; P < 0.00001). High-frequency rTMS improved patient disability (SMD = − 0.45; 95% CI − 0.75, − 0.16; P = 0.003). High-frequency rTMS led to no advantage in reducing the number of abortive medications (MD = − 1.10; 95% CI − 3.28, 1.08; P = 0.32), but it increased the occurrence of adverse events (RR = 1.69; 95% CI 1.09, 2.64; P = 0.02).

Conclusions

High-frequency rTMS reduces the frequency of attacks and headache intensity in migraine patients and improves the patient’s disability, but it also increases adverse events.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge Xiaoling Zhong for stimulating us into writing this manuscript.

Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine-Neurology I, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Medical Group), Qingdao, 266042, Shandong, China

    Yumin Jiang & Ling Wang

  2. Department of Health Management Center, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Medical Group), Qingdao, 266042, Shandong, China

    Chen Yuan

  3. Department of Intensive Care Unit, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Medical Group), Qingdao, 266042, Shandong, China

    Pengpeng Sun

  4. Department of Colorectal and Anal Surgery, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Medical Group), Qingdao, 266042, Shandong, China

    Changjia Li

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  1. Yumin Jiang
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  2. Chen Yuan
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  3. Pengpeng Sun
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  4. Changjia Li
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Contributions

Yumin Jiang and Chen Yuan searched the literature and consulted Changjia Li to resolve disagreements. Pengpeng Sun performed the statistical analysis. The manuscript was drafted by Yumin Jiang and Changjia Li. All authors approved the final version, and Wang Ling had final responsibility for the decision to submit for publication.

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Correspondence to Ling Wang.

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This is a meta-analysis, and ethical approval is not needed. Informed consent is not applicable for this systematic review.

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Jiang, Y., Yuan, C., Sun, P. et al. Efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (rTMS) for migraine: a meta-analysis of randomized controlled trials. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02570-5

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