TMS and Migraines

A portable transcranial magnetic stimulation (tms) device has been successfully used to reduce migraine headaches. Migraine headaches are usually pulsating and localized to one side of the brain. They typically can last from 4 to 72 hours. Migraine headaches are often accompanied by nausea, vomiting and sensivity to sight/hearing. Researchers performed a multi-center clinical trial of 164 patients. They found that 39 percent of patients were migraine free two hours after TMS treatment compared to only 22 percent recieving sham/placebo TMS. The adverse reactions from this device were also minimal and similar to the sham/placebo.

The cause of migraines is currently unknown. Migraines have been associated with altered cortical brain excitability. Migraines and epilepsy have been linked to one another, suggesting a common brain disturbance.

"The comorbidity between epilepsy and migraine has been well known for a century, yet it is still not fully understood; the two disorders also share some risk factors, symptoms, and preventive drug therapy. A series of clinical observations and scientific data support the hypothesis of alteration of cortical excitability as a possible mechanism underlying their pathology, with both disorders characterized by transient paroxysmal neurological disturbance. So far, the numerous pathophysiological mechanisms responsible for neuronal hyperexcitability have only been studied in familial hemiplegic migraine (FHM), but they do suggest a link between migraine and epilepsy."

Researchers have used low frequency TMS stimulation to reduce hyperexcitability of the occipital cortex. Low frequency stimulation reduces activity in that specific area of the brain and this resolves migraine symptoms.

"Recent studies showed hyperexcitability of the occipital cortex in subjects affected by migraine with aura. It has been shown that 1 Hz repetitive transcranial magnetic stimulation (rTMS) reduces excitability of visual cortex in normal subjects. The aim of the study was to investigate the effects of low frequency (1 Hz) rTMS on visual cortical excitability by measuring changes in phosphene threshold (PT) in subjects with migraine with aura."

Transcranial direct current stimulation has also been used for migraines and may be a cheaper alternative to TMS.

"If the tDCS treatment makes it through clinical trials, migraine sufferers may end up with a treatment safe enough to use without a physician present and whose only side effect would be a slight tingling sensation. Adding to the good news: “I can’t see it costing more than $10,” Zaghi says."

Currently neither TMS nor tDCS is approved by the FDA for the treatment of migraines. However you may be able to get treatment off label at certain brain stimulation centers around the US.

You can watch a CBS news video about this new technology below.