Transcranial direct current stimulation in chronic migraine: a pilot trial combining cathodal visual and anodal DLPFC stimulation.
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1
University of Liège, Belgium
Background
Contrary to episodic migraine, chronic migraine (CM) is associated with sensitisation of visual cortex and depression that is characterized by left DLPFC hypoactivity. Transcranial direct current stimulation (tDCS) is able to activate (anode) or inhibit (cathode) the underlying cortex,thus of potential therapeutic interest in CM.
Aim
To explore the effect in CM of simultaneous tDCS over the visual cortex and lDLPFC with a novel tDCS Cefaly° device.
Method
We recruited 20 patients suffering from chronic migraine(n=15) and medication overuse headache(n=5)(ICHD-III beta 1.3 or 8.2).All had stable preventive treatment for at least 2 months. We applied anodal tDCS over F3 and cathodal over Oz: intensity 2 mA, duration 20min, daily for 8 weeks. Patients filled in headache diaries before (T0), during (T1) and after treatment (T2). We recorded CHEPS, QST, nBR and VEP at baseline (T0), immediately after (T1) and after 8 weeks (T2).
Results
tDCS had no effects on VEP and QST; increased nBR habituation at T1 (p=.05) and made CHEPS slope less negative at T2 (p=.04) in CM. Total headache days decreased from 21.9/month at T0 to 15.7/month at T2 (-28.4%,p= 0.004).Severe migraine attacks were reduced by 43.7% (p= 0.05),headache hours by 30.2% (p= 0.02). The 50% responder rate for migraine days was 33.3%. There was no significant therapeutic effect in MOH patients.
Conclusion
These results suggests that tDCS aiming at inhibiting the visual cortex while activating lDLPFC has an interesting potential in chronic migraine patients who are notoriously difficult to treat. A sham-controlled trial is thus worthwhile.
Keywords:
tDCS,
Neuromodulation,
CHEPS,
DLPFC,
habituation
Conference:
Belgian Brain Council 2014
MODULATING THE BRAIN: FACTS, FICTION, FUTURE, Ghent, Belgium, 4 Oct - 4 Oct, 2014.
Presentation Type:
Oral Presentation
Topic:
Clinical Neuroscience
Citation:
Baschi
R,
Sava
S,
La Salvia
V,
De Pasqua
V,
Schoenen
J and
Magis
D
(2014). Transcranial direct current stimulation in chronic migraine: a pilot trial combining cathodal visual and anodal DLPFC stimulation..
Conference Abstract:
Belgian Brain Council 2014
MODULATING THE BRAIN: FACTS, FICTION, FUTURE.
doi: 10.3389/conf.fnhum.2014.214.00051
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Received:
30 Jun 2014;
Published Online:
13 Jul 2014.
*
Correspondence:
Dr. Roberta Baschi, University of Liège, Liège, Belgium, roberta.baschi@gmail.com