Table 2 Summary of the main results of previous systematic reviews and meta-analysis focusing on neuromodulation in migraine treatment
| Â | First author | Date | Journal | Topic | Main conclusion |
|---|---|---|---|---|---|
rTMS / tDCS | Fregni | 2020 | Int J Neuropsychopharmacol | tDCS in neurological and psychiatric disorders | tDCS is probably effective (Level B) for migraine |
Baptista | 2019 | Pain reports | Latin American and Caribbean consensus on rTMS and tDCS for chronic pain management | Level B recommendation for anodal tDCS over M1 or Oz/Cz tDCS. Level B recommendation for high-frequency rTMS over M1 | |
Feng | 2019 | Headache | rTMS and tDCS | Excitatory M1 stimulation showed significant effects on reducing headache intensity and frequency with a large effect size. Excitatory DLPFC stimulation showed a significant effect on the headache intensity with a large effect size but no reduction of frequency of headache attacks. | |
Stilling | 2019 | Headache | TMS and tDCS for the treatment of headache | rTMS has moderate evidence that it contributes to reductions in headache frequency, duration, intensity, abortive medication use, depression, and functional impairment. | |
Shirahige | 2016 | Headache | rTMS and tDCS | tDCS reduced migraine attacks frequency (SMD: −0.75; 95% CI: −1.25 to − 0.24; P = .004). There was no effect of rTMS. | |
TMS | Lan | 2017 | J Headache Pain | Efficacy of single-pulse TMS in randomized controlled trials | Single-pulse TMS is effective for the acute treatment of migraine with aura after the first attack. The efficacy of TMS on chronic migraine was not significant. |
ONS | Cadalso | 2018 | J Oral Facial Pain Headache | ONS in intractable primary headache disorders | 3 RCTs: significant reduction of headache days per month (difference = −3.061; 95% confidence interval [CI] = −5.162 to −0.961; P = .004) compared to sham |
Yang | 2016 | Pain pratice | ONS for migraine | Results from 4 retrospective studies and 1 case series indicated that ONS significantly reduced the number of days with headache in patients with migraine. However, the evidence of ONS efficacy established by 5 RCTs was limited. | |
Chen | 2015 | Plos One | ONS for chronic migraine | 3 multicenter RCTs: mean reduction of 2.59 days (95% CI 0.91 to 4.27, I2 = 0%) of prolonged, moderate to severe headache per month at 3 months compared with a sham control. | |
VNS | Lai | 2020 | Neuromodulation | Cervical non-invasive VNS for migraine and cluster headache | No significant differences in headache days reduction (SMD = −0.159; 95% CI, − 0.357 to 0.04; p = 0.117) between nVNS and sham-device treatment. |
TENS | Stanak | 2020 | J Neurol Sci | Impact of TENS on prevention and acute treatment of episodic and chronic migraine | Reduction of migraine attacks (0.67 less migraine attacks per month), migraine days (1.74 less migraine days per month), headache days (2.28 less headache days per month). Concerning acute treatment, significant reduction of pain at 1/2/24 h post-acute treatment. |
Tao | 2018 | J Headache Pain | TENS in randomized controlled trials for migraine | Significant reduction of monthly headache days (SMD: −0.48; 95% CI: − 0.73 to - 0.23; P < 0.001) |