title: Magnetic stimulation of the upper trapezius muscles in patients with migraine - A pilot study.
abstract: BACKGROUND
  Repetitive peripheral magnetic stimulation (rPMS) has been applied to musculoskeletal pain conditions. Since recent data show that migraine and tension-type headache (TTH) might be closely related to peripheral muscular pain in the neck and shoulder region (supporting the concept of the trigemino-cervical complex (TCC)), this pilot study explores the acceptance of rPMS to the upper trapezius muscles in migraine (partly in combination with TTH).
  
  
  METHODS
  We used rPMS to stimulate active myofascial trigger points (aTrPs) of the upper trapezius muscles in 20 young adults suffering from migraine. Acceptance was assessed by a standardized questionnaire, whereas self-rated effectiveness was evaluated by headache calendars and the Migraine Disability Assessment (MIDAS). Algometry was performed to explore the local effect of rPMS on the muscles.
  
  
  RESULTS
  Acceptance of rPMS was shown in all subjects without any adverse events, and rPMS had a statistically significant impact on almost every parameter of the headache calendar and MIDAS. Among others, the number of migraine attacks (p < 0.001) and migraine intensity (p = 0.001) significantly decreased regarding pre- and post-stimulation assessments. Accordingly, 100.0% of subjects would repeat the stimulation, while 90.0% would recommend rPMS as a treatment option for migraine.
  
  
  CONCLUSIONS
  rPMS might represent a promising tool to alleviate migraine symptoms within the context of myofascial pain. This might be due to stimulation-dependent modulation of the peripheral sensory effect within the TCC in migraine. However, sham-controlled studies with larger and more homogeneous cohorts are needed to prove a potential beneficial effect. Ethics Committee Registration Numbers: 356-14 and 447/14.
authors.affiliation: Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: Nico.Sollmann@tum.de.
authors.forename: Nico
authors.initials: N
authors.lastname: Sollmann
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Integrated Social Pediatric Center, iSPZ Hauner, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Lindwurmstr. 4, 80337 Munich, Germany. Electronic address: F.Trepte-Freisleder@tum.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Trepte-Freisleder
authors.affiliation: Institute of Social Pediatrics and Adolescents Medicine, Ludwig-Maximilians-Universität, Haydnstr. 5, 80367 Munich, Germany. Electronic address: Lucia.Albers@med.uni-muenchen.de.
authors.forename: Lucia
authors.initials: L
authors.lastname: Albers
authors.affiliation: kbo-Kinderzentrum München, Social Pediatrics, Technische Universität München, Heiglhofstr. 63, 81377 Munich, Germany. Electronic address: Nikolai.Jung@tum.de.
authors.forename: Nikolai H
authors.initials: NH
authors.lastname: Jung
authors.affiliation: kbo-Kinderzentrum München, Social Pediatrics, Technische Universität München, Heiglhofstr. 63, 81377 Munich, Germany. Electronic address: Volker.Mall@tum.de.
authors.forename: Volker
authors.initials: V
authors.lastname: Mall
authors.affiliation: Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: Bernhard.Meyer@tum.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meyer
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Integrated Social Pediatric Center, iSPZ Hauner, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Lindwurmstr. 4, 80337 Munich, Germany; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität, Munich, Germany. Electronic address: Florian.Heinen@med.uni-muenchen.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Heinen
authors.affiliation: Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: Sandro.Krieg@tum.de.
authors.forename: Sandro M
authors.initials: SM
authors.lastname: Krieg
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Integrated Social Pediatric Center, iSPZ Hauner, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Lindwurmstr. 4, 80337 Munich, Germany; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität, Munich, Germany. Electronic address: Mirjam.Landgraf@med.uni-muenchen.de.
authors.forename: Mirjam N
authors.initials: MN
authors.lastname: Landgraf
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy / Q000379:methods*; D008297:Male; D008881:Migraine Disorders / Q000628:therapy*; D009209:Myofascial Pain Syndromes / Q000150:complications; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D064171:Superficial Back Muscles; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D061028:Trigger Points; D055815:Young Adult
keywords: Active myofascial trigger points; Headache; Migraine; Repetitive peripheral magnetic stimulation (rPMS); Trigemino-cervical complex (TCC)