Abstract
Background: Low intensity, high-frequency transcranial alternating current stimulation (tACS) applied over the motor cortex decreases the amplitude of motor evoked potentials. This double-blind, placebo-controlled parallel group study aimed to test the efficacy of this method for acute management of migraines. Methods: The patients received either active (0.4 mA, 140 Hz) or sham stimulation for 15 min over the visual cortex with the number of terminated attacks two hours post-stimulation as the primary endpoint, as a home therapy option. They were advised to treat a maximum of five migraine attacks over the course of six weeks. Results: From forty patients, twenty-five completed the study, sixteen in the active and nine in the sham group with a total of 102 treated migraine attacks. The percentage of terminated migraine attacks not requiring acute rescue medication was significantly higher in the active (21.5%) than in the sham group (0%), and the perceived pain after active stimulation was significantly less for 2–4 h post-stimulation than after sham stimulation. Conclusion: tACS over the visual cortex has the potential to terminate migraine attacks. Nevertheless, the high drop-out rate due to compliance problems suggests that this method is impeded by its complexity and time-consuming setup.
Highlights
Transcranial magnetic (TMS) and direct current stimulation applied over the visual or motor areas have shown efficacy in the acute and prophylactic treatment of migraines in placebo-controlled studies [1,2,3,4,5,6,7,8,9,10,11,12]
Four patients had no migraine attacks during the study period, two patients decided to withdraw without giving any reason and one patient experienced a panic attack before the stimulation
The demographical characteristics of the patients related to the disease did not differ significantly between the active and sham stimulation groups (t-test, p > 0.1)
Summary
Transcranial magnetic (TMS) and direct current stimulation (tDCS) applied over the visual or motor areas have shown efficacy in the acute and prophylactic treatment of migraines in placebo-controlled studies [1,2,3,4,5,6,7,8,9,10,11,12] (for a recent meta-analyses see [13]). High-frequency transcranial alternating current stimulation (tACS) applied over the motor cortex decreases the amplitude of motor evoked potentials This double-blind, placebo-controlled parallel group study aimed to test the efficacy of this method for acute management of migraines. Methods: The patients received either active (0.4 mA, 140 Hz) or sham stimulation for 15 min over the visual cortex with the number of terminated attacks two hours post-stimulation as the primary endpoint, as a home therapy option. They were advised to treat a maximum of five migraine attacks over the course of six weeks. The high drop-out rate due to compliance problems suggests that this method is impeded by its complexity and time-consuming setup
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