Skip to main content

Advertisement

SpringerLink
Log in

Transcranial direct current stimulation (tDCS) and its influence on analgesics effectiveness in patients suffering from migraine headache

  • Original article
  • Published:
Pharmacological Reports Aims and scope Submit manuscript

Abstract

Background

Headache is one of the most common conditions troubling nearly 45% of the world’s population. Migraine headache itself, being more common among women, affects 7–18% of people. As much as 20–30% of the population report accompanying aura and neurological symptoms. In many cases, migraine headache can be effectively treated with suitably selected pharmacotherapies which include drugs used in symptomatic treatment. Frequent occurrence of the condition is treated with prophylaxis, which often fails. Neuromodulating methods are part of the multidirectional treatment and they may be valuable complement to pharmacotherapy.

Methods

Our study evaluates the impact of the transcranial direct current stimulation (tDCS) on the consumption of drugs and on pain conditions (frequency, duration, intensity). We recruited 50 patients with migraine headache (30 with aura, 20 without aura) refractory to pharmacological therapy. In 30 patients (18 with aura, 12 without aura) previous unsatisfactory treatment was supplemented with tDCS performed tenfold. 20 patients (12 with aura, 8 without aura) from a control group were treated with pharmacological methods The observation continued for 30 days after the stimulation.

Results

After tDCS, a reduction in the consumption of analgesics and triptans was reported. Additionally, we monitored pain intensity decrease during pain episodes, duration of episodes and the number of pain days. The subjective assessment of pain reduction in migraine patients encompassed 36–40% after tDCS much more effective in comparison to group with only pharmacotherapy (10–12.5%).

Conclusions

The study suggests that tDCS may be safe and useful clinical tool in migraine prophylaxis and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Buse DC, Manack AN, Fanning KM, Serrano D, Reed ML, Turkel CC, et al. Chronic migraine prevalence, disability, and socio demographic factors: results from the American Migraine Prevalence and Prevention Study. Headache 2012;52 (10):1456–70.

    Article  Google Scholar 

  2. Gallagher RM, Kunkel R. Migraine medication attributes important for patient compliance: concerns about side effects may delay treatment. Headache 2003;43(1):36–43.

    Article  Google Scholar 

  3. Goadsby PJ, Sprenger T. Current practice and future directions in the prevention and acute management of migraine. Lancet Neurol 2010;9:285–98.

    Article  Google Scholar 

  4. Dasilva AF, Mendonca ME, Zaghi S, Lopes M, Dossantos MF, Spierings EL, et al. tDCS-induced analgesia and electrical fields in pain-related neural networks in chronic migraine. Headache 2012;52(8):1283–95.

    Article  Google Scholar 

  5. Viganò A, D’Elia TS, Sava SL, Auvé M, De Pasqua V, Colosimo A, et al. Transcranial Direct Current Stimulation (tDCS) of the visual cortex: a proof-of-concept study based on interictal electrophysiological abnormalities in migraine. J Headache Pain 2013;14:23.

    Article  Google Scholar 

  6. Jürgens T. Neuromodulation in primary headaches. Pain Clin Updates Int Assoc Study Pain (IASP) 2012;20(5):1–7.

    Google Scholar 

  7. Antal A, Ambrus GG, Chaieb L. Toward unraveling reading-related modulations of tDCS-induced neuroplasticity in the human visual cortex. Front Psychol 2014;5:642.

    Article  Google Scholar 

  8. Antal A, Kriener N, Lang N, Boros K, Paulus W. Cathodal transcranial direct current stimulation of the visual cortex in the prophylactic treatment of migraine. Cephalalgia 2011;31:820–8.

    Article  Google Scholar 

  9. Shirahige L, Melo L, Nogueira F, Rocha S, Monte-Silva K. Efficacy of noninvasive brain stimulation on pain control in migraine patients: a systematic review and meta-analysis. Headache 2016;56(10):1565–96.

    Article  Google Scholar 

  10. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders. 3rd edition International Headache Society; 2013 Cephalalgia 33(9):629–80.

  11. Zheng X, Alsop DC, Schlaug G. Effects of transcranial direct current stimulation (tDCS) on human regional cerebral blood flow. Neuroimage 2011;58(1):26–33.

    Article  Google Scholar 

  12. Penolazzia B, Pastoreb M, Mondinia S. Electrode montage dependent effects of transcranial direct current stimulation on semantic fluency. Behav Brain Res 2013;248:129–35.

    Article  Google Scholar 

  13. Goadsby PJ, Sprenger T. Current practice and future directions in the prevention and acute management of migraine. Lancet Neurol 2010;9:285–98.

    Article  Google Scholar 

  14. Antal A, Nitsche MA, Paulus W. External modulation of visual perception in humans. Neuroreport 2001;12:3553–5.

    Article  CAS  Google Scholar 

  15. Fenstermacher N, Levin M, Ward T. Pharmacological prevention of migraine. BMJ 2011;18:342.

    Google Scholar 

  16. Lipton RB, Silberstein SD. Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache 2015;55(Suppl. 2):103–22.

    Article  Google Scholar 

  17. Silberstein SD. Preventive migraine treatment. Neurol Clin 2009;27(2):429–43.

    Article  Google Scholar 

  18. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 2000;527 (Pt3):633–9.

    Article  CAS  Google Scholar 

  19. Fritsch B, Reis J, Martinowich K, Schambra HM, Ji Y, Cohen LG, et al. Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning. Neuron 2010;66(2):198–204.

    Article  CAS  Google Scholar 

  20. Woods AJ, Antal A, Bikson M, Boggio PS, Brunoni AR, Celnik P, et al. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol 2016;127(2):1031–48.

    Article  CAS  Google Scholar 

  21. Nitsche MA, Liebetanz D, Antal A, Lang N, Tergau F, Paulus W. Modulation of cortical excitability by weak direct current stimulation?technical, safety and functional aspects. Suppl Clin Neurophysiol 2003;56:255–76.

    Article  Google Scholar 

  22. Lang N, Siebner HR, Ward NS, Lee L, Nitsche MA, Paulus W, et al. How does transcranial DC stimulation of the primary motor cortex alter regional neuronal activity in the human brain? Eur J Neurosci 2005;22(2):495–504.

    Article  Google Scholar 

  23. DosSantos MF, Love TM, Martikainen IK, Nascimento TD, Fregni F, Cummiford C, et al. Immediate effects of tDCS on the µ-opioid system of a chronic pain patient. Front Psychiatry 2012;3(93):1–6.

    Google Scholar 

  24. Vigano A, D’Elia TS, Sava SL, Auvé M, De Pasqua V, Colosimo A, et al. Transcranial Direct Current Stimulation (tDCS) of the visual cortex: a proof-of-concept study based on interictal electrophysiological abnormalities in migraine. J Headache Pain 2013;14:23.

    Article  Google Scholar 

  25. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul 2012;5(3):175–95.

    Article  Google Scholar 

  26. Darkow R, Martin A, Würtz A, Flöel A, Meinzer M. Transcranial direct current stimulation effects on neural processing in post-stroke aphasia. Hum Brain Mapp 2016, doi:https://doi.org/10.1002/hbm.23469.

    Article  Google Scholar 

  27. O’Brien AT, Amorim R, Rushmore RJ, Eden U, Afifi L, Dipietro L, et al. Motor cortex neurostimulation technologies for chronic post-stroke pain: implications of tissue damage on stimulation currents. Front Hum Neurosci 2016;10:545.

    Article  Google Scholar 

  28. Auvichayapat P, Janyacharoen T, Rotenberg A, Tiamkao S, Krisanaprakornkit T, Sinawat S, et al. Migraine prophylaxis by anodal transcranial direct current stimulation, A, randomized, placebo-Controlled trial. J Med Assoc Thai 2012;95(8):1003.

    PubMed  Google Scholar 

  29. Knotkova H, Leuschner Z, Soto E, Greenberg A, Cruciani RA. Evaluation of outcomes from transcranial direct current stimulation (tDCS) for the treatment of chronic pain. J Pain 2013;14:64.

    Article  Google Scholar 

  30. Vecchio E, Ricci K, Montemurno A, Delussi M, Invitto S, de Tommaso M. Effects of left primary motor and dorsolateral prefrontal cortex transcranial direct current stimulation on laser-evoked potentials in migraine patients and normal subjects. Neurosci Lett 2016;626:149–57.

    Article  CAS  Google Scholar 

  31. DosSantos MF, Ferreira N, Toback RL, Carvalho AC, DaSilva AF. Potential mechanisms supporting the value of motor cortex stimulation to treat chronic pain syndromes. Front Neurosci 2016;10:18.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pain Research and Treatment, Chair of Anesthesiology and Intensive Therapy, Jagiellonian University Medical College, Kraków, Poland

    Anna Przeklasa-Muszyńska, Magdalena Kocot-Kępska & Jan Dobrogowski

  2. Department of Otolaryngology, Jagiellonian University Medical College, Kraków, Poland

    Maciej Wiatr

  3. Department of Pain Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland

    Joanna Mika

Authors
  1. Anna Przeklasa-Muszyńska
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Magdalena Kocot-Kępska
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan Dobrogowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maciej Wiatr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joanna Mika
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Anna Przeklasa-Muszyńska or Joanna Mika.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Przeklasa-Muszyńska, A., Kocot-Kępska, M., Dobrogowski, J. et al. Transcranial direct current stimulation (tDCS) and its influence on analgesics effectiveness in patients suffering from migraine headache. Pharmacol. Rep 69, 714–721 (2017). https://doi.org/10.1016/j.pharep.2017.02.019

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1016/j.pharep.2017.02.019

Keywords

Search

Navigation