A feasible repetitive transcranial magnetic stimulation clinical protocol in migraine prevention.
OBJECTIVE
This case series was conducted to determine the clinical feasibility of a repetitive transcranial magnetic stimulation protocol for the prevention of migraine (with and without aura).


METHODS
Five patients with migraines underwent five repetitive transcranial magnetic stimulation sessions separated in 1- to 2-week intervals for a period of 2 months at a single tertiary medical center. Repetitive transcranial magnetic stimulation was applied to the left motor cortex with 2000 pulses (20 trains with 1s inter-train interval) delivered per session, at a frequency of 10 Hz and 80% resting motor threshold. Pre- and post-treatment numerical rating pain scales were collected, and percent reductions in intensity, frequency, and duration were generated.


RESULTS
An average decrease in 37.8%, 32.1%, and 31.2% were noted in the intensity, frequency, and duration of migraines post-repetitive transcranial magnetic stimulation, respectively. A mean decrease in 1.9±1.0 (numerical rating pain scale ± standard deviation; range: 0.4-2.8) in headache intensity scores was noted after the repetitive transcranial magnetic stimulation sessions.


CONCLUSIONS
The tested repetitive transcranial magnetic stimulation protocol is a well-tolerated, safe, and effective method for migraine prevention.
Department of Neurology, UC San Diego Medical Center, San Diego, CA, USA; VA San Diego Health Care System, San Diego, CA, USA.
Shawn
S
Zardouz
VA San Diego Health Care System, San Diego, CA, USA; Center for Pain Medicine, UC San Diego Health, San Diego, CA, USA.
Lei
L
Shi
VA San Diego Health Care System, San Diego, CA, USA; Center for Pain Medicine, UC San Diego Health, San Diego, CA, USA.
Albert
A
Leung
Repetitive transcranial magnetic stimulation; migraine; protocol