Transcranial magnetic stimulation as a new approach in medication overuse headache: a pilot study: [Doc 504]

Granato et al. The Journal of Headache and Pain 2013, 14(Suppl 1):P168 http://www.thejournalofheadacheandpain.com/content/14/S1/P168

POSTER PRESENTATION Open Access

Transcranial magnetic stimulation as a new approach in medication overuse headache: a pilot study

A Granato1*, S Musho Ilbeh1, F Trov1, M Borelli2, G Granello1, M Semenic1, F Monti1, G Pizzolato1

From The European Headache and Migraine Trust International Congress London, UK. 20-23 September 2012

Background

Repetitive TMS (rTMS) is effective in migraine prophylaxis.

Introduction

To study the efficacy of high-frequency rTMS in medication overuse headache (MOH).

Methods

A prospective, double-blind, randomized, placebo-controlled trial on patients suffering from MOH consecutively presenting in a six-month period in the Headache Centre of Trieste was performed. Patients were randomized into the rTMS or the sham-TMS group. Treatment consisted of 10 consecutively TMS sessions delivered on left dorsolateral prefrontal cortex, each session being 10 trains of 2-s duration, separated by 30-s pause, 20 Hz frequency, 100% motor threshold intensity. Demographic and clinical information, MIDAS score, headache days (HD), hours of headache (HH), and symptomatic drugs (SD) in the 3 months before (t1), and in the first (t2) and second month (t3) after stimulation were analysed using SPSS 14.0.

Results

We enrolled 8 patients (7 F, 1 M; mean age 44 11), four patients undewent rTMS and four sham-TMS. All patients were migraineurs without aura as initial primary headache. We found, in both rTMS and sham-TMS group, no significant difference between the 3 months before and the 2 months after stimulation (rTMS: HD= 22 6 t1 vs 22 11 t2 vs 19 14 t3, HH= 223 205 t1 vs 219 198 t2 vs 205 196 t3, SD= 22 10 t1 vs 18 7 t2 vs 16 8 t3;

sham-TMS: HD= 22 5 t1 vs 12 6 t2 vs 13 8 t3, HH= 180 117 t1 vs 99 73 t2 vs 97 28 t3, SD= 22 10 t1 vs 16 3 t2 vs 17 4 t3). MIDAS score significantly reduced in rTMS group at a three-month evaluation (111 29 vs 42 27; p=0.03).

Conclusions

Our preliminary data suggest that high-frequency rTMS is not useful to treat MOH, however the small sample does not allow to draw safe conclusions.

Author details

1Department of Medical, Surgical and Health Sciences, Headache Centre, University of Trieste, Trieste, Italy. 2Department of Mathematics and Geosciences, University of Trieste, Trieste, Italy.

Published: 21 February 2013

References1. Brighina F, Piazza A, Vitello G, Aloisio A, Palermo A, Daniele O, Fierro B: http://www.ncbi.nlm.nih.gov/pubmed/15546593?dopt=Abstract

Web End =rTMS of the prefrontal cortex in the treatment of chronic migraine: a http://www.ncbi.nlm.nih.gov/pubmed/15546593?dopt=Abstract

Web End =pilot study. J Neurol Sci 2004, 227(1):67-71.

2. Lipton RB, Pearlman SH: http://www.ncbi.nlm.nih.gov/pubmed/20430320?dopt=Abstract

Web End =Transcranial magnetic simulation in the http://www.ncbi.nlm.nih.gov/pubmed/20430320?dopt=Abstract

Web End =treatment of migraine. Neurotherapeutics 2010, 7(2):204-12.

doi:10.1186/1129-2377-14-S1-P168Cite this article as: Granato et al.: Transcranial magnetic stimulation as a new approach in medication overuse headache: a pilot study. The Journal of Headache and Pain 2013 14(Suppl 1):P168.

1Department of Medical, Surgical and Health Sciences, Headache Centre, University of Trieste, Trieste, ItalyFull list of author information is available at the end of the article

2013 Granato et al; licensee Springer. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0

Web End =http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.