Transcranial Direct Current Stimulation

  • Anna AmbrosiniEmail author
  • Gianluca Coppola
Part of the Headache book series (HEAD)


Migraine is the most prevalent neurological disorder worldwide; nevertheless, its pathophysiology is not yet completely understood. Recent scientific progresses in migraine research disclosed new possible targets for novel non-pharmacological treatment strategies for migraine treatment, such as noninvasive neuromodulation methods. Among them, transcranial direct current stimulation (tDCS) gave promising results in pilot studies. tDCS is a noninvasive, safe, and relatively not expensive technique of cortical electrical stimulation, aimed to modulate cortical activity in many ways, according to the stimulated sites and the polarity used. Unfortunately, large sham-controlled trials are not yet available to confirm its potential use as a preventative treatment for migraine.


Migraine pathophysiology Preventative treatments Cortical neuromodulation Transcranial direct current stimulation tDCS 



Dorsolateral prefrontal cortex




Motor cortex


Transcranial direct current stimulation


Transcranial magnetic stimulation


Visual-evoked potential


  1. 1.
    Coppola G, Di Lorenzo C, Serrao M, et al. Pathophysiological targets for non-pharmacological treatment of migraine. Cephalalgia. 2016;36:1103–11.CrossRefGoogle Scholar
  2. 2.
    De Tommaso M, Ambrosini A, Brighina F, et al. Altered processing of sensory stimuli in patients with migraine. Nat Rev Neurol. 2014;10(3):144–55. Scholar
  3. 3.
    Judit A, Sandor PS, Schoenen J. Habituation of visual and intensity dependence of auditory evoked cortical potentials tends to normalize just before and during the migraine attack. Cephalalgia. 2000;20:714–9.CrossRefGoogle Scholar
  4. 4.
    Coppola G, Ambrosini A, Di Clemente L, et al. Interictal abnormalities of gamma band activity in visual evoked responses in migraine: an indication of thalamocortical dysrhythmia? Cephalalgia. 2007;27:1360–7.CrossRefGoogle Scholar
  5. 5.
    Viganò A, D’Elia TS, Sava SL, 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.CrossRefGoogle Scholar
  6. 6.
    Cortese F, Pierelli F, Bove I, et al. Anodal transcranial direct current stimulation over the left temporal pole restores normal visual evoked potential habituation in interictal migraineurs. J Headache Pain. 2017;18:70.CrossRefGoogle Scholar
  7. 7.
    Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol. 2000;527(Pt 3):633–9.CrossRefGoogle Scholar
  8. 8.
    Nitsche MA, Paulus W. Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology. 2001;57:1899–901.CrossRefGoogle Scholar
  9. 9.
    Pellicciari MC, Brignani D, Miniussi C. Excitability modulation of the motor system induced by transcranial direct current stimulation: a multimodal approach. NeuroImage. 2013;83:569–80.CrossRefGoogle Scholar
  10. 10.
    Antal A, Kincses TZ, Nitsche MA, et al. Manipulation of phosphene thresholds by transcranial direct current stimulation in man. Exp Brain Res. 2003;150:375–8.CrossRefGoogle Scholar
  11. 11.
    Antal A, Kincses TZ, Nitsche MA, et al. Excitability changes induced in the human primary visual cortex by transcranial direct current stimulation: direct electrophysiological evidence. Invest Ophthalmol Vis Sci. 2004;45:702–7.CrossRefGoogle Scholar
  12. 12.
    Turi Z, Paulus W, Antal A. Functional neuroimaging and transcranial electrical stimulation. Clin EEG Neurosci. 2012;43:200–8.CrossRefGoogle Scholar
  13. 13.
    Di Lazzaro V, Rothwell J, Capogna M. Noninvasive stimulation of the human brain: activation of multiple cortical circuits. Neurosci. 2018;24(3):246–60.Google Scholar
  14. 14.
    Bohotin V, Fumal A, Vandenheede M, et al. Effects of repetitive transcranial magnetic stimulation on visual evoked potentials in migraine. Brain. 2002;125:912–22.CrossRefGoogle Scholar
  15. 15.
    Brigo F, Storti M, Nardone R, et al. Transcranial magnetic stimulation of visual cortex in migraine patients: a systematic review with meta-analysis. J Headache Pain. 2012;13:339–49.CrossRefGoogle Scholar
  16. 16.
    Ambrosini A, Iezzi E, Perrotta A, et al. Correlation between habituation of visual-evoked potentials and magnetophosphene thresholds in migraine: a case-control study. Cephalalgia. 2016;36:258–64.CrossRefGoogle Scholar
  17. 17.
    Antal A, Kriener N, Lang N, et al. Cathodal transcranial direct current stimulation of the visual cortex in the prophylactic treatment of migraine. Cephalalgia. 2011;31:820–8.CrossRefGoogle Scholar
  18. 18.
    Dasilva A, Mendonca ME, Zaghi S, et al. tDCS-induced analgesia and electrical fields in pain-related neural networks in chronic migraine. Headache. 2012;52:1283–95.CrossRefGoogle Scholar
  19. 19.
    Auvichayapat P, Janyacharoen T, Rotenberg A, et al. Migraine prophylaxis by anodal transcranial direct current stimulation, a randomized, placebo-controlled trial. J Med Assoc Thail. 2012;95:1003–12.Google Scholar
  20. 20.
    Rocha S, Melo L, Boudoux C, et al. Transcranial direct current stimulation in the prophylactic treatment of migraine based on interictal visual cortex excitability abnormalities: a pilot randomized controlled trial. J Neurol Sci. 2015;349:33–9.CrossRefGoogle Scholar
  21. 21.
    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 Reports. 2017;69:714–21.CrossRefGoogle Scholar
  22. 22.
    Andrade SM, de Brito Aranha REL, de Oliveira EA, et al. Transcranial direct current stimulation over the primary motor vs. prefrontal cortex in refractory chronic migraine: a pilot randomized controlled trial. J Neurol Sci. 2017;378:225–32.CrossRefGoogle Scholar
  23. 23.
    Sprenger T, Borsook D. Migraine changes the brain: neuroimaging makes its mark. Curr Opin Neurol. 2012;25:252–62.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.IRCCS Neuromed, Headache ClinicPozzilliItaly
  2. 2.Department of Medico-Surgical Sciences and BiotechnologiesSapienza University of Rome Polo PontinoLatinaItaly

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