Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials

The Journal of Headache and Pain

Bing-Yan Zeng¹  Yu-Chen Cheng²  Kuan-Pin Su³  Chih-Sung Liang⁴  Chih-Wei Hsu⁵  Ming-Kung Wu⁵  Pao-Yen Lin⁶  Tien-Yu Chen⁷  Brendon Stubbs⁸  Mein-Woei Suen⁹  Ping-Tao Tseng^1,10  Yi-Cheng Wu^1,11  Cheng-Ta Li^1,12  Chao-Ming Hung^1,13  Andre F. Carvalho^1,14  Yow-Ling Shiue^1,15  Yu-Kang Tu^1,16  Andre R. Brunoni^1,17 

[1] Department of Internal Medicine, E-DA Dachang Hospital, Kaohsiung, Taiwan;Department of Neurology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan;Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan;Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan;Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan;College of Medicine, China Medical University, Taichung, Taiwan;An-Nan Hospital, China Medical University, Tainan, Taiwan;Department of Psychiatry, Beitou branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan;Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan;Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist, 833, Kaohsiung City, Taiwan;Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist, 833, Kaohsiung City, Taiwan;Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan;Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan;Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK;Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK;Positive Ageing Research Institute (PARI), Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK;Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan;Gender Equality Education and Research Center, Asia University, Taichung, Taiwan;Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan;Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan;Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan;Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan;Prospect Clinic for Otorhinolaryngology & Neurology, No. 252, Nanzixin Road, Nanzi District, 81166, Kaohsiung City, Taiwan;Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan;Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan;Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan;Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, No. 201, Sec. 2, Shipai Road, Beitou District, 11267, Taipei City, Taiwan;Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Functional Neuroimaging and Brain Stimulation Lab, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, 11267, Taipei City, Taiwan;Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan;School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan;Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia;Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan;Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan;Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan;Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da USP, São Paulo, Brazil;Departamento de Ciências Médicas, Faculdade de Medicina da USP, São Paulo, Brazil;

关键词: Migraine;    Non-invasive brain stimulation;    Non-invasive nerve stimulation;    Network meta-analysis;    Response rate;   

DOI  :  10.1186/s10194-022-01401-3

来源: Springer

【 摘 要 】

BackgroundCurrent pharmacologic prophylactic strategies for migraine have exhibited limited efficacy, with response rates as low as 40%–50%. In addition to the limited efficacy, the acceptability of those pharmacologic prophylactic strategies were unacceptable. Although noninvasive brain/nerve stimulation strategies may be effective, the evidence has been inconsistent. The aim of this network meta-analysis (NMA) was to compare strategies of noninvasive brain/nerve stimulation for migraine prophylaxis with respect to their effectiveness and acceptability.MethodsThe PubMed, Embase, ScienceDirect, ProQuest, ClinicalTrials.gov, ClinicalKey, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov databases were systematically searched to date of June 4th, 2021 for randomized controlled trials (RCTs). Patients with diagnosis of migraine, either episodic migraine or chronic migraine, were included. All NMA procedures were conducted under the frequentist model.ResultsNineteen RCTs were included (N = 1493; mean age = 38.2 years; 82.0% women). We determined that the high frequency repetitive transcranial magnetic stimulation (rTMS) over C3 yielded the most decreased monthly migraine days among all the interventions [mean difference = − 8.70 days, 95% confidence intervals (95%CIs): − 14.45 to − 2.95 compared to sham/control groups]. Only alternating frequency (2/100 Hz) transcutaneous occipital nerve stimulation (tONS) over the Oz (RR = 0.36, 95%CIs: 0.16 to 0.82) yielded a significantly lower drop-out rate than the sham/control groups did.ConclusionsThe current study provided a new direction for the design of more methodologically robust and larger RCTs based on the findings of the potentially beneficial effect on migraine prophylaxis in participants with migraine by different noninvasive brain/nerve stimulation, especially the application of rTMS and tONS.Trial registrationCRD42021252638. The current study had been approval by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).

【 授权许可】

CC BY