Halker Singh RB, Ailania J and Robbins MS. Headache 2019 doi: 10.1111/head.13586As there have been devices that have gained FDA clearance for migraine and cluster headache since previous review articles on neuromodulation have been published, our paper will focus on those key studies. We will also briefly review devices in development and also highlight the use of neuromodulation in certain groups who may otherwise have limited treatment options, including the elderly, children, and women who are pregnant.
Starling AJ, Tepper SJ, Marmura MJ, Shamim EA, Robbins MS, Hindiya N, Charles AC, Goadsby PJ, Lipton RB, Silberstein SD, Gelfand AA, Chiacchierini RP and Dodick DW. Cephalalgia. 2018. 0(0) I-II. DOI: 10.1177/0333102418762525.Abstract: The objective of this clinical trial was to evaluate the efficacy and tolerability of sTMS for the preventive treatment of migraine. The primary effectiveness endpoint, mean reduction of headache days, was met and was statistically significant. Secondary effectiveness endpoints were all met: reduction in acute medication days, reduction in HIT-6 score and a reduction in total headache days of any pain intensity. sTMS was well tolerated. Based on the ESPOUSE study and a previous UK Study, the FDA cleared sTMS for the prophylactic treatment of migraine headache.
Irwin SL, Qubty W, Allen E, Patniyot I, Goadsby PJ, Gelfand AA. Headache 2018. doi: 10.1111/head.13284To assess the feasibility, tolerability, and patient acceptability of single-pulse transcranial magnetic stimulation (sTMS) for migraine prevention in adolescents in an open-label pilot study.
Wei DY, Greenwood FS, Murgatroyd FD, Goadsby PJ. Headache. 2018; 58: 295-297.We present a patient with chronic migraine with a cardiac pacemaker, who had tried unsuccessfully several migraine preventives with either poor efficacy or tolerability. With involvement of the cardiology team, we tested the effect of sTMS on her pacemaker and found it to be a safe and effective option for her.
Lloyd DO, Okine BN, Jones MF, Al-Kaisy A, Lambru G, McMahon SB, Andreou AP. Abstract: 18th Congress of the International Headache Society, September 7 -11, 2017; Vancouver, BC Canada.Abstract: This study aimed to investigate the cortical actions of sTMS in a migraine model. The data show that sTMS, when applied at intensities below the motor activation threshold suppresses spontaneous and glutamate-induced neuronal activity at the visual cortex and increases the electrical threshold required for a CSD induction. Collectively, these findings suggest that sTMS reduces cortical excitability by increasing the threshold of activation or cortical neurons.
Andreou AP, Holland PR, Akerman S, Summ O, Fredrick J, Goadsby PJ. Brain. 2016;139(7):2002-2014. doi:10.1093/brain/aww118.Abstract: The potential mechanisms of action of transcranial magnetic stimulation were investigated, using a trans-cortical approach, in preclinical migraine models. It was demonstrated that cortical spreading depression can be blocked in vivo using single pulse transcranial magnetic stimulation and may have a novel thalamocortical modulatory capacity that may explain the efficacy of magnetic stimulation in the treatment of migraine with and without aura.
Bhola R, Kinsella E, Giffin N, et al. J Headache Pain. 2015;16:535. doi:10.1186/s10194-015-0535-3.Abstract: Migraine patients with and without aura were treated with sTMS over 12 weeks and reported significant pain relief along with a reduction in monthly headache days, demonstrating that sTMS may be a valuable addition to options for the treatment of both episodic and chronic migraine.
Dodick DW, Schembri CT, Helmuth M, Aurora SK. Headache. 2010;50(7):1153-1163. doi:10.1111/j.1526-4610.2010.01697.x/abstract.Summary: In an analysis of studies of single-pulse and repetitive TMS, potential and theoretical safety concerns of transcranial (TMS) are reviewed. Safety concerns associated with sTMS in the context of its use as a migraine treatment are specifically considered. It is concluded that the safety of sTMS in clinical practice is supported by biological, empirical, and clinical trial evidence and that it may offer a safe therapeutic alternative to the currently prescribed drugs for patients who suffer from migraine.
Lipton RB, Dodick DW, Silberstein SD, et al. The Lancet Neurology. 2010;9(4):373-380.\r\ndoi:http://dx.doi.org/10.1016/S1474-4422(10)70054-5Summary: The efficacy and safety of a new portable sTMS device for acute treatment of migraine with aura were assessed in a randomised, double-blind, parallel-group, 2-phase, sham-controlled study at 18 centers in the USA. Early treatment resulted in increases freedom from pain at 2 hours and absence of pain at 24 and 48 hours after treatment.
Starling AJ, Dodick DW, Chiacchierini RP. Abstract, American Academy of Neurology’s 63rd Annual Meeting; April 9–16, 2011; Honolulu, HI.View full text
Ahmed F, Goadsby PJ, Bhola R, Reinhold T, Brüggenjürgen B. Abstract, IHC 17th Congress of the International Headache Society; May 14–17, 2015; Valencia, Spain.View full text
Bhola R, Giffin N, Ahmed F. Abstract, 2013 International Headache Congress; June 27–30, 2013; Boston, MA.View full text
Andreou AP, Fredrick J, Goadsby PJ. Abstract, European Headache and Migraine Trust International Congress; September 20–23, 2012; London, UK.View full text
Clarke BA, Upton ARM, Kamath MV, Al-Harbi T, Castellanos CM. J Headache Pain. 2006;7:341-346. doi:10.1007/s10194-006-0329-8.Link to journal
Lipton RB, Pearlman SH. Neurotherapeutics. 2010;7(2):204-212. doi:10.1016/j.nurt.2010.03.002.Link to journal
Mohammad YM, Kothari R, Hughes G, et al. Abstract, American Headache Society annual meeting; June 2006; Los Angeles, CA.View full text
Bhola R, Kinsella E, Ahmed F, Goadsby PJ. Abstract, 4th European Headache and Migraine Trust International Congress; September 18–21, 2014; Copenhagen, Denmark.View full text
Bhola R, Kinsella E, Goadsby PJ. Abstract, 56th Annual Meeting of the American Headache Society; June 26–29, 2014; Los Angeles, CA.View full text