Abstract Details

Title Repetitive Transcranial Magnetic Stimulation (rTMS) as Preventive Treatment of Chronic Migraine: A Safe Approach with a Promising Effect

Topic Clinical Neurophysiology

Presentation(s) S59 - (-)

Poster/Presentation
Number 005

Objective

Background Chronic migraine (CM) is a disabling condition and a challenging therapeutic problem since prophylactic drugs often have inadequate response or unacceptable side effects. A few pilot studies have explored the possibility of applying repetitive transcranial magnetic stimulation (rTMS) in migraine for acute or chronic treatment with controversial results.

Design/Methods Thirty patients (median age 34 years, 70% female), affected by CM -resistant to preventive pharmacological therapies and in clinical stability in the previous 3 months- participated to the study. rTMS was applied to prefrontal areas at 110% motor threshold intensity and 20 Hz frequency. Three rTMS sessions per week were performed for six weeks with a follow-up visit at 4, 8, 12, 24 weeks, after end of treatment. Patients underwent headache diary assessment, MIDAS, BDI, SF36.

Results No side effects were evident during the study. Ten patients presented with a significative reduction (50%) in headache days (p<0.0001) and attacks (p=0.02), and pain intensity (p=0.005); a parallel decrease in the number of acute medications (p<0.01)- was evident, together with improvement in quality of life items (p<0.01). A partial response to treatment (20% - 40% attacks reduction) occurred in 7 other patients. 5 patients reported no modification in their headache.

Conclusions The use of rTMS could be a major step forward in CM treatment, particularly in patients where available drugs are ineffective, poorly tolerated or contraindicated rTMS may be able in modulating the activity of cortico-subcortical and cortico-cortical pathways involved in pain control.

Authors/Disclosures
Dacia Dalla Libera, MD (San Raffaele Hospital) PRESENTER	No disclosure on file
Parul Houston	No disclosure on file
	No disclosure on file
Arturo Nuara	No disclosure on file
	No disclosure on file
	No disclosure on file
Raffaella Chieffo, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Giancarlo Comi, MD (University Vita-Salute)	Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.
Letizia M. Leocani, MD (University Vita-Salute San Raffaele, INSPE)	Dr. Leocani has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche . Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Med-ex learning.

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