title: rTMS of the prefrontal cortex in the treatment of chronic migraine: a pilot study.
abstract: A recent fMRI study showed that dorsolateral prefrontal cortex (DLPFC) exerts an inhibitory control on pain pathways in humans. We investigated whether high-frequency rTMS over left DLPFC could ameliorate chronic migraine. Treatment consisted of 12 rTMS sessions, delivered in alternate days over left DLPFC. Sham rTMS was used as placebo. Eleven patients were randomly assigned to the rTMS (n=6) or to the placebo (n=5) treatment. Measures of attack frequency, headache index, number of abortive medications (outcome measures) were recorded in the month before, during and in the month after treatment. Subjects treated by rTMS showed a significant reduction of the outcome measures during and in the month after the treatment as compared to the month before treatment. No significant differences in the outcome measures were observed in the placebo group. High-frequency rTMS over left DLPFC was able to ameliorate chronic migraine. This is in agreement with the suggested role of DLPFC in pain control.
authors.affiliation: Neurophysiological Unit, University of Palermo, Palermo, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Brighina
authors.forename: Aurelio
authors.initials: A
authors.lastname: Piazza
authors.forename: Gaetano
authors.initials: G
authors.lastname: Vitello
authors.forename: Antonina
authors.initials: A
authors.lastname: Aloisio
authors.forename: Antonio
authors.initials: A
authors.lastname: Palermo
authors.forename: Ornella
authors.initials: O
authors.lastname: Daniele
authors.forename: Brigida
authors.initials: B
authors.lastname: Fierro
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease / Q000628:therapy; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D006261:Headache / Q000628:therapy; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000628:therapy*; D010865:Pilot Projects; D017397:Prefrontal Cortex / Q000528:radiation effects*; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome