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. 2023 Aug;123(4):1481-1493.
doi: 10.1007/s13760-023-02277-z. Epub 2023 May 15.

Non-invasive brain stimulation treatments for migraine prophylaxis: a network meta-analysis of randomized controlled trials

Yi-Lin Chen  1 , Qian Chen  1 , Li-Wen Li  1 , Can Hua  1 , Xin-Yue Zhang  1 , Hui Zheng  2
Affiliations

Non-invasive brain stimulation treatments for migraine prophylaxis: a network meta-analysis of randomized controlled trials

Yi-Lin Chen et al. Acta Neurol Belg. 2023 Aug.

Abstract

Background and objectives: Migraine is a major public health problem owing to its long disease duration and disease relapse. Non-invasive brain stimulation treatments were reported effective for the management of migraine, but the comparative effectiveness of three main NIBSs, rTMS, nVNS, and tDCS, has not been studied. We aimed to explore the relative efficacy of rTMS, tDCS, and nVNS in migraine prophylaxis by using network meta-analysis (NMA).

Methods: We searched OVID Medline, Embase, Cochrane Controlled Register of Trials, and Web of Science from inception to 1 January 2022. Randomized controlled trials that reported the efficacy of rTMS, tDCS or nVNS in the prophylactic treatment of migraine were included. The primary outcome was monthly migraine frequency, and secondary outcomes were headache intensity and the impact of headaches on daily life. The relative effects of the treatments in contrast to the others were measured by using standard mean difference (SMD).

Results: We included 31 trials with 1659 participants. Fourteen trials were rated as low risk of bias. The results showed that tDCS (SMD - 1.58; 95%CI, - 2.38 to - 0.79; P-score = 0.92) had the largest effect on migraine frequency when compared with sham interventions in reducing monthly migraine frequency, and tDCS had a larger effect than rTMS (SMD - 0.62; 95%CI, - 1.81 to 0.57) and nVNS (SMD - 1.39; 95%CI, - 3.27 to 0.49). tDCS had also the largest effect in reducing pain intensity when compared with sham intervention (SMD - 1.49; 95%CI, - 2.46 to - 0.52) and rTMS (SMD - 0.48; 95%CI, - 2.06 to 1.09).

Conclusions: For the prophylactic treatment of migraine, tDCS was relatively more effective than rTMS and nVNS. Head-to-head comparison trials are needed to confirm the findings.

Keywords: Migraine prophylaxis; Network meta-analysis; Non-invasive brain stimulation.

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References

    1. Global, regional, and national burden of neurological disorders. 2019 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology. 18:459–480. https://doi.org/10.1016/s1474-4422(18)30499-x
    1. Aurora SK, Dodick DW, Turkel CC et al (2010) Onabotulinumtoxin A for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia 30:793–803. https://doi.org/10.1177/0333102410364676 - DOI - PubMed
    1. Diener HC, Dodick DW, Aurora SK et al (2010) OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalgia 30:804–814. https://doi.org/10.1177/0333102410364677 - DOI - PubMed
    1. Whyte CA (2009) Tepper S %J E review of neurotherapeutics adverse effects of medications commonly used in the treatment of migraine. Exp Rev Neurotherapeutics 9(1379):1391. https://doi.org/10.1586/ern.09.47 - DOI
    1. Moisset X, Pereira B, Ciampi de Andrade D et al (2020) Neuromodulation techniques for acute and preventive migraine treatment: a systematic review and meta-analysis of randomized controlled trials. J Headache Pain 21:142. https://doi.org/10.1186/s10194-020-01204-4 - DOI - PubMed - PMC

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