Kopfschmerz

Efficacy of tDCS in chronic migraine: A multiprotocol randomized controlled trial

OBJECTIVE

Given the prevalence and complicated pathophysiology of migraine, unknown or varied mechanisms of action of available monotherapies or add-on therapies, and their broad range of adverse effects, it is imperative to manage migraine symptoms using a non-invasive, multifunctional, and alternate monotherapy with no negative impacts.

METHODS

We used a single-blind, randomized, sham-controlled design with baseline, post-test, and 24-weeks follow-up measurements to assess the efficacy of transcranial Direct Current Stimulation (tDCS) in chronic migraine. A total of 150 participants were randomly assigned to the five groups (i.e., allocation ratio of 1:1:1:1:1). Each group received tDCS-intervention for 11 consecutive-weeks (25 sessions; each session = two consecutive montages; each montage = a 20 min duration, 2000 μA intensity).

RESULTS

The multivariate analysis of variance showed significant (p <.05) reductions in chronic migraine symptoms in the four intervention groups. Compared with the sham (η² < 0.18) and other protocols (two = η² > 0.42; three = η² > 0.40; four = η² > 0.51), protocol one [l. anode at the right ventrolateral prefrontal cortices, cathode at the left dorsomedial and superior frontal gyrus-first montage; anode at the right primary motor area, cathode at the medial crosstalk of hemispheres-second montage] showed a larger effect size (η² > 0.59) in the present trial.

CONCLUSIONS

With the applied protocols of the present trial, tDCS can be used as an effective intervention for the prophylactic and therapeutic treatment of chronic migraine. However, while the second protocol was the least effective, the first was the most effective at reducing migraine symptoms.

SIGNIFICANCE

To our knowledge, the present trial is the first study to cover the gaps of the earlier ones, including the parameters like the site of stimulation, electrode range distribution and field intensity, number of sessions, session design, and sample size.

Growth of Headache Research: A 1983-2014 bibliometric study

Aim This study charts the growth of the scientific journal literature on headache for 30+ years (1983-2014). Methods Using the Web of Science, articles published in four two-year periods (1983-1984, 1993-1994, 2003-2004, 2013-2014) from journals indexed in the Science Citation Index Expanded database were retrieved and analyzed. Results From 1983-1984 to 2013-2014, the scientific literature on headache increased nearly fourfold (3.8) from 468 to 1776 articles; the number of participating countries more than doubled (26 to 67); and the two most prolific countries in each period were the USA and Italy. While several European countries (Italy, Germany, UK and Denmark) were among the top 10 in each period, the notable appearance of Turkey, China and Brazil among the top 10 in 2013-2014 indicates the growing geographic spread of publications on headache research. Meanwhile, the comet-like distribution of journals has not changed: two journals, Headache and Cephalalgia, persist throughout as the nucleus, with the tail increasing more than threefold from 141 journals in 1983-1984 to 462 in 2013-2014. Conclusion Our study follows the recent growth and spread of the scientific literature on headache research and should stimulate further bibliometric investigation in this field.