Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author CONFORTO, Adriana B. FMUSP-HC
AMARO JR., Edson FMUSP-HC
GONCALVES, Andre L.
MERCANTE, Juliane P. P.
GUENDLER, Vera Z.
FERREIRA, Josione R.
KIRSCHNER, Clara C. F. B.
PERES, Mario F. P.
dc.date.issued 2014
dc.identifier.citation CEPHALALGIA, v.34, n.6, p.464-472, 2014
dc.identifier.issn 0333-1024
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/7465
dc.description.abstract Background High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (rTMS-DLPFC) is an effective treatment for depression. Preliminary studies indicated beneficial effects of rTMS-DLPFC on pain relief in patients treated for depression, and in patients with chronic migraine. Methods In this randomized, double-blind, parallel-group, single-center, proof-of-principle clinical trial, we tested the hypothesis that 23 sessions of active rTMS-DLPFC delivered over eight weeks would be feasible, safe and superior to sham rTMS to decrease the number of headache days in 18 patients with chronic migraine without severe depression. Per-protocol analysis was performed. Results rTMS-DLPFC applied over eight weeks was feasible and safe in patients with chronic migraine. Contrary to our primary hypothesis, the number of headache days decreased significantly more in the sham group than in the group treated with active rTMS-DLPFC at eight weeks. Average decrease in headache days was >50% in the sham group, indicating a powerful placebo response. Pain intensity improved in both groups to a similar extent. Conclusions Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.
dc.description.sponsorship · Albert Einstein Israelite Hospital Teaching and Research Institute/Instituto de Ensino e Pesquisa do Hospital Israelita Albert Einstein [IEP.PE.08-0122]
· Brazilian National Council for Scientific and Technological Development/Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [472407/2007-4]
dc.language.iso eng
dc.publisher SAGE PUBLICATIONS LTD
dc.relation.ispartof Cephalalgia
dc.rights restrictedAccess
dc.subject Placebo; dorsolateral prefrontal cortex; transcranial magnetic stimulation; chronic migraine; pain
dc.subject.other major depression; pain; safety; acupuncture; inventory; headache; efficacy; cortex; rtms
dc.title Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine
dc.type article
dc.rights.holder Copyright SAGE PUBLICATIONS LTD
dc.description.group LIM/15
dc.description.group LIM/44
dc.identifier.doi 10.1177/0333102413515340
dc.identifier.pmid 24326236
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author CONFORTO, Adriana B.:HC:LIM/15
hcfmusp.author AMARO JR., Edson:FM:MDR
hcfmusp.author.external · GONCALVES, Andre L.:Hosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa, BR-05601901 Sao Paulo, Brazil
· MERCANTE, Juliane P. P.:Hosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa, BR-05601901 Sao Paulo, Brazil
· GUENDLER, Vera Z.:Hosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa, BR-05601901 Sao Paulo, Brazil
· FERREIRA, Josione R.:Hosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa, BR-05601901 Sao Paulo, Brazil
· KIRSCHNER, Clara C. F. B.:Hosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa, BR-05601901 Sao Paulo, Brazil
· PERES, Mario F. P.:Hosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa, BR-05601901 Sao Paulo, Brazil; Univ Fed Sao Paulo, Neurol & Neurosci Postgrad Program, Sao Paulo, Brazil
hcfmusp.origem.id WOS:000334157600009
hcfmusp.origem.id 2-s2.0-84899000445
hcfmusp.publisher.city LONDON
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
dc.identifier.eissn 1468-2982
hcfmusp.citation.scopus 41
hcfmusp.citation.wos 42
hcfmusp.affiliation.country Brasil


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