Neurostimulation Against Migraine

Can electrical neurostimulation be used to help migraine patients? A new study indicates that modification of neural excitability over the visual cortex reduces the occurrence of migraine attacks significantly.

Migraine affects about one million people in Switzerland, and every attack interferes with everyday living. It is important to minimize the impact of these headaches – ideally, using well-tolerated therapeutic approaches. Neuronal hyperpolarization that spreads across the cortex might be causing these attacks and transcranial direct current stimulation (tDCS) can be used to modify cortical excitability. In our study we tested if tDCS, applied to the visual cortex, effectively prevents migraine attacks in patients suffering from episodic migraine. Since we think it is important to develop a therapeutic approach that can be applied easily at home, we decided to study self-administered tDCS, that means the patients placed the electrodes themselves according to our instructions. After four weeks of daily tDCS, we found that self-administered neurostimulation significantly reduced the number of monthly migraine days by about 40% for several months. However, once the migraine attack occurred, pain intensity or duration of the attack was not reduced.

Our study indicates that neurostimulation is rather effective as short-term prophylaxis in patients with episodic migraine. Notably, it also shows that patients can safely self-administer the stimulation at home. We are currently analyzing the impact of tDCS on brain function and structure, and hope to gain insights into the mechanisms through which this technique affects pathophysiology. Future studies should investigate the effectiveness of different placements of electrodes not only in episodic but also in chronic migraine.

By: Lars Michels, Department of Neuroradiology, University Hospital Zurich

Reference: Long-Term Effects of Self-Administered Transcranial Direct Current Stimulation in Episodic Migraine Prevention: Results of a Randomized Controlled Trial. Heiko Pohl, Marius Moisa, Hans-H Jung, Kathrin Brenner, Jessica Aschmann, Franz Riederer, Christian C Ruff, Jean Schoenen, Roger Luechinger, Lukas Widmer, Jens A Petersen, Andreas R Gantenbein, Peter S Sandor, Lars Michels Neuromodulation. 2020 Oct 21 Article