Migraine Prophylaxis by Anodal Transcranial
Direct Current Stimulation, A Randomized,
Placebo-Controlled Trial
Paradee Auvichayapat MD*,a, Taweesak Janyacharoen PhD**,a, Alexander Rotenberg MD, PhD***,b,
Somsak Tiamkao MD****,a, Thawatchai Krisanaprakornkit MD*****,a, Supat Sinawat MD*,a,
Wiyada Punjaruk MD, PhD*,a, Bandit Thinkhamrop PhD******, Narong Auvichayapat MD*******,a
a Member of Noninvasive Brain Stimulation Research Group of Thailand
b Consultant of Noninvasive Brain Stimulation Research Group of Thailand
* Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
** Department of Physical therapist, Faculty of Associated Medical Science, Khon Kaen University, Khon Kaen, Thailand
*** Division of Epilepsy and Clinical Neurophysiology, Department of Neurology Children’s Hospital,
Harvard Medical School, Boston, MA
****
Affiliation :
Background : Migraine is a common headache syndrome in adult populations. Prophylaxis is necessary to improve the
quality of life but some patients with migraine have contraindication or suffer from side effects of medication, and therefore,
establishing non-medical, neuromodulatory approaches is necessary. Past evidence had shown that consecutive motor
cortex (M1) stimulation with anodal transcranial direct current stimulation (tDCS) was effective to relieve central pain.
Objective : To determine whether 20 consecutive days of the left M1 can be an effective prophylactic treatment for migraine.
Material and Method: Forty-two episodic migraine patients who had never received any prophylactic treatment, failed
prophylactic treatment, or discontinued treatment due to adverse events were recruited in the present study. Patients were
randomized to receive either active tDCS or sham tDCS 1mA, 20 m for 20 consecutive days and followed up for 12 weeks.
Differences between and within groups were determined using repeated measures ANOVA. The level of significance was set
at p < 0.05.
Results : Thirty-seven patients participated in the final analyses (active: n = 20, sham: n = 17). Between-groups comparison
of attack frequency, pain intensity, and abortive medications used were performed at 4, 8, and 12 weeks after treatment.
The results showed statistically significant reduction in attack frequency and abortive medications at week 4 and 8 after
treatment. The pain intensity was statistically significant reduced at week 4, 8, and 12. All patients tolerated the tDCS well
without any serious adverse events.
Conclusion : The present study suggests that anodal M1 tDCS may be a safe and useful clinical tool in migraine prophylaxis.
The mechanism of action of anodal tDCS on neuromodulation in migraine patients needs further investigation.
Keywords : Noninvasive brain stimulation, Transcranial direct current stimulation, Migraine, Pain, Chronic headache
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