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Review
. 2021 Apr 27:14:1171-1183.
doi: 10.2147/JPR.S295704. eCollection 2021.

A Systematic Review and Meta-Analysis on the Efficacy of Repeated Transcranial Direct Current Stimulation for Migraine

Guoshuai Cai #  1 , Zhu Xia #  2 , Leigh Charvet  3 , Feifei Xiao  4 , Abhishek Datta  5   6 , X Michelle Androulakis #  7   8
Affiliations
Review

A Systematic Review and Meta-Analysis on the Efficacy of Repeated Transcranial Direct Current Stimulation for Migraine

Guoshuai Cai et al. J Pain Res. .

Abstract

Purpose: Transcranial direct current stimulation (tDCS) may have therapeutic potential in the management of migraine. However, studies to date have yielded conflicting results. We reviewed studies using repeated tDCS for longer than 4 weeks in migraine treatment, and performed meta-analysis on the efficacy of tDCS in migraine.

Methods: In this meta-analysis, we included the common outcome measurements reported across randomized controlled trials (RCTs). Subgroup analysis was performed at different post-treatment endpoints, and with different stimulation intensities and polarities.

Results: Five RCTs were included in the quantitative meta-analysis with a total of 104 migraine patients. We found a significant reduction of migraine pain intensity (MD: -1.44; CI: [-2.13, -0.76]) in active vs sham tDCS treated patients. Within active treatment groups, pain intensity and duration were significantly improved from baseline after tDCS treatment (intensity MD: -1.86; CI: [-3.30, -0.43]; duration MD: -4.42; CI: [-8.11, -0.74]) and during a follow-up period (intensity MD: -1.52; CI: [-1.84, -1.20]; duration MD: -1.94; CI: [-3.10, -0.77]). There was a significant reduction of pain intensity by both anodal (MD: -1.74; CI: [-2.80, -0.68]) and cathodal (MD: -1.49; CI: [-1.89, -1.09]) stimulation conditions.

Conclusion: tDCS treatment repeated over days for a period of 4 weeks or more is effective in reducing migraine pain intensity and duration of migraine episode. The benefit of tDCS can persist for at least 4 weeks after the completion of last tDCS session. Both anodal and cathodal stimulation are effective for reducing migraine pain intensity.

Keywords: meta-analysis; migraine; neuromodulation; transcranial direct current stimulation (tDCS).

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
PRISMA flow diagram for study selection. Notes: Adapted from Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097.
Figure 2
Figure 2
Risk of bias summary. Green “+“, red “-” and yellow “?“ were used to classify the risk of bias of each criteria as: “low risk of bias“, ”high risk of bias“ and “unclear“.
Figure 3
Figure 3
Pain intensity Meta-analysis in treatment group. (A) Between group analysis; (B) after versus baseline and follow-up versus baseline; (C) subgroup analysis considering type of stimulation; (D) subgroup analysis considering current intensity.
Figure 4
Figure 4
Duration of migraine episode Meta-analysis in treatment group. (A) Between group analysis; (B) after versus baseline and follow-up versus baseline; (C) subgroup analysis considering type of stimulation; (D) subgroup analysis considering current intensity.
See this image and copyright information in PMC

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