Study: Brain Stimulation Does Not Aid Migraine Pain

New research finds little evidence to support using noninvasive brain stimulation (NIBS) techniques to prevent and treat episodic and chronic migraines.

In an effort to evaluate the efficacy of NIBS on pain control in migraine patients, investigators conducted a systematic review of controlled clinical trials. In total, the authors searched 6 databases: MEDLINE (via PubMed), LILACS (via BIREME), CINAHL (via EBSCO), Scopus (via EBSCO), Web of Science, and CENTRAL.
______________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Aura Symptoms Are Variable in Patients With Migraine
Study: No Link Between Migraine and Silent Brain Infarcts
______________________________________________________________________________________________________________________________________________________________________

For the study, 2 independent authors searched for randomized controlled clinical trials published until January 2016 that involved the use of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) in patients with migraine. The authors assessed studies meeting the eligibility criteria, examining methodological quality using the Cochrane tool for assessing risk of bias. Information about pain intensity (primary outcome), migraine attacks, painkiller intake, and adverse effects were extracted, according to the researchers. 

Overall, 8 studies were included in the quantitative analysis, including 153 migraine patients who received NIBS, and 143 receiving sham NIBS. In the meta-analysis, the authors did not find significant results for pain intensity, migraine attacks, and for painkiller intake. Subgroup analysis considering only tDCS effects, however, did reveal a decrease for pain intensity and painkiller intake, while subgroup analysis for TMS did not indicate significant effects for any outcome.

Ultimately, "low or very low quality of evidence suggests that our primary outcome evaluation failed to find support for the superiority of NIBS over sham treatment," the authors wrote. "Although, subgroup analysis reveals that tDCS have moderate to high effects and could be a promising non-pharmacological alternative to pain control, mainly for painkiller intake reduction. However, there is a need for larger controlled trials with methodological rigor, which could increase the power of result inference."

—Mark McGraw

Reference

Shirahige L, Melo L, Noguera F, Rocha S, Monte-Silva K. Efficacy of noninvasive brain stimulation on pain control in migraine patients: a systematic review and meta-analysis [published online November 15, 2016]. Headache. doi:10.1111/head.12981.