Prophylaxis Of High-frequency Transcranial Magnetic Stimulation For Migraine

Objective Migraine is a common life-long disorder, current studies of its underlying pathogenesis are widely ranged, many are still in preliminary theory stage. Medication is the main treatment for migraine, which usually aim at termination of pain progression, reduction of recurrence, alleviation of associated symptoms, therefore less adverse reaction and small economic burden can be achieved[1], many studies in recent years have shown that long-term drug misuse cause drug tolerance and addiction [2], which complicate the patient’s condition, many migraine sufferers have to abandon the treatment, endure frequent headache pain. Transcranial magnetic stimulation has been gradually applied in [3,4] many neuropsychological diseases and have been shown to be safe, effective and non-invasive [5], Our study intends to investigate the efficacy of highfrequency repetitive transcranial magnetic stimulation in the treatment of migraine.Methods 70 patients with migraine were randomly divided into r TMS treatment group and sham stimulation group, with 35 cases in each group. in the study group, stimulation were delivered to the left frontal cortex corresponding to the hot spot of the right abductor digiti minimi for 4 sessions in 1 week. For stimulation,100% of the motor threshold were used. Each session of r TMS consisted of 600 pulses which were given in 10 trains, each consisting of 60 pulses at 10 Hz with intertrain interval of 60 s. The sham stimulation was given in the same manner(including the coil type, the placement location and the parameters) using a sham coil for the control group. All patients were followed up weekly for 4 weeks, headache frequency, VAS score, functional disability, instant medication for episodic attacks and adverse events were noted. results were processed with the SPSS(version 16.0).Results In the study group(n = 35),after 1 week of treatment, headache frequency, VAS score, functional disability, instant medication for episodic attacks dropped(2.51 ± 0.95, 3.97± 1.25,1.40± 0.91,2.46 ± 1.12 respectively) compared with those before treatment(5.10 ± 0.82, 7.63 ± 1.59,3.11 ±0.76,5.46 ± 3.57 respectively), the difference were significant(P = 0.001, P = 0.0001, P = 0.0001, P = 0.0001 respectively), the trends can also be seen at 2 weeks, 3 weeks and 4 weeks of follow-up. In the control group(n = 35),after 1 week of treatment, VAS scores dropped(P = 0.001, P = 0.0001, P = 0.0001, P = 0.03) at1, 2, 3, 4 weeks of follow-up compared with those before treatment, headache frequency decreased(P = 0.001, P = 0.0001, P = 0.006)at1, 2 and 3 weeks of follow-up, functional disability, instant medication for episodic attacks also improved(P = 0.0001, P = 0.04 and P = 0.0001, P = 0.001)at 1, 2 weeks of followup, but the difference were not obvious than that in the study group.Conclusion For patients with migraine, high frequency r TMS can reduce the headache frequency and severity, improve the quality of life, and the curative effect is sustainable for 1 month. Therefore, high frequency r TMS can be used to improve the condition of patients with migraine.