Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine

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dc.contributor.authorConforto, Adriana B.
dc.contributor.authorAmaro, Edson
dc.contributor.authorGoncalves, Andre L.
dc.contributor.authorMercante, Juliane P. P.
dc.contributor.authorGuendler, Vera Z.
dc.contributor.authorFerreira, Josione R.
dc.contributor.authorKirschner, Clara C. F. B.
dc.contributor.authorPeres, Mario F. P. [UNIFESP]
dc.contributor.institutionHosp Israelita Albert Einstein
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:37:16Z
dc.date.available2016-01-24T14:37:16Z
dc.date.issued2014-05-01
dc.description.abstractBackground High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (rTMS-DLPFC) is an effective treatment for depression. Preliminary studies indicated beneficial effects of rTMS-DLPFC on pain relief in patients treated for depression, and in patients with chronic migraine.Methods in this randomized, double-blind, parallel-group, single-center, proof-of-principle clinical trial, we tested the hypothesis that 23 sessions of active rTMS-DLPFC delivered over eight weeks would be feasible, safe and superior to sham rTMS to decrease the number of headache days in 18 patients with chronic migraine without severe depression. Per-protocol analysis was performed.Results rTMS-DLPFC applied over eight weeks was feasible and safe in patients with chronic migraine. Contrary to our primary hypothesis, the number of headache days decreased significantly more in the sham group than in the group treated with active rTMS-DLPFC at eight weeks. Average decrease in headache days was >50% in the sham group, indicating a powerful placebo response. Pain intensity improved in both groups to a similar extent.Conclusions Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.en
dc.description.affiliationHosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa, BR-05601901 São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Hosp Clin São Paulo Univ, Clin Neurol Div, BR-05508 São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Ctr Interdisciplinary Res Appl Neurosci NAPNA, BR-05508 São Paulo, Brazil
dc.description.affiliationHosp Clin São Paulo Univ, Inst Radiol, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Neurol & Neurosci Postgrad Program, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Neurol & Neurosci Postgrad Program, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipAlbert Einstein Israelite Hospital Teaching and Research Institute/Instituto de Ensino e Pesquisa do Hospital Israelita Albert Einstein
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipIDAlbert Einstein Israelite Hospital Teaching and Research Institute/Instituto de Ensino e Pesquisa do Hospital Israelita Albert Einstein: IEP.PE.08-0122
dc.description.sponsorshipIDCNPq: 472407/2007-4
dc.format.extent464-472
dc.identifierhttp://dx.doi.org/10.1177/0333102413515340
dc.identifier.citationCephalalgia. London: Sage Publications Ltd, v. 34, n. 6, p. 464-472, 2014.
dc.identifier.doi10.1177/0333102413515340
dc.identifier.issn0333-1024
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/37754
dc.identifier.wosWOS:000334157600009
dc.language.isoeng
dc.publisherSage Publications Ltd
dc.relation.ispartofCephalalgia
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.uk.sagepub.com/aboutus/openaccess.htm
dc.subjectPlaceboen
dc.subjectdorsolateral prefrontal cortexen
dc.subjecttranscranial magnetic stimulationen
dc.subjectchronic migraineen
dc.subjectpainen
dc.titleRandomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraineen
dc.typeinfo:eu-repo/semantics/article
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