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High-rate repetitive transcranial magnetic stimulation in migraine prophylaxis: a randomized, placebo-controlled study

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Abstract

Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for pain but there is no class 1 study on its role in migraine prophylaxis. In this study we report the efficacy and safety of high-rate rTMS in migraine prophylaxis. Adult migraine patients having >4 attacks/month were randomized to high-rate rTMS or sham stimulation. Stimulation in the form of 10 Hz rTMS, 600 pulses in 10 trains were delivered to the hot spot of the right abductor digiti minimi in 412 s. Three sessions were delivered on alternate days. The outcome was defined at 1 month. The primary outcome measures were reduction in headache frequency and severity >50 % as assessed by the Visual Analogue Scale (VAS). The secondary outcome measures were functional disability, rescue medication and adverse events. Fifty patients each were randomized to rTMS or sham stimulation. The baseline characteristics of rTMS and sham stimulation groups were similar. At 1 month, headache frequency (78.7 vs. 33.3 %; P = 0.0001) and VAS score (76.6 vs. 27.1 %; P = 0.0001) improved significantly in the patients receiving rTMS compared to those in the sham stimulation group. Functional disability also improved significantly in rTMS group (P = 0.0001). Only one patient following rTMS developed transient drowsiness and was withdrawn from the study. This study provides evidence of the efficacy and safety of 10 Hz rTMS in migraine prophylaxis.

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Acknowledgments

We thank Mr. S. P. Singh for technical assistance and Mr. Rakesh Kumar Nigam for secretarial help.

Conflicts of interest

The authors declare no conflict of interest.

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The research has been approved by the Institutional Ethics Committee, SGPGIMS, Lucknow.

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Authors and Affiliations

  1. Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, India

    Usha K. Misra, Jayantee Kalita & Sanjeev K. Bhoi

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  1. Usha K. Misra
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  2. Jayantee Kalita
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  3. Sanjeev K. Bhoi
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Correspondence to Usha K. Misra.

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Misra, U.K., Kalita, J. & Bhoi, S.K. High-rate repetitive transcranial magnetic stimulation in migraine prophylaxis: a randomized, placebo-controlled study. J Neurol 260, 2793–2801 (2013). https://doi.org/10.1007/s00415-013-7072-2

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  • DOI: https://doi.org/10.1007/s00415-013-7072-2

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