Klinische Neurophysiologie 2011; 42 - A207
DOI: 10.1055/s-0031-1272678

Efficacy of repetitive cathodal transcranial direct current stimulation of the visual cortex in the prophylaxis of menstrual migraine

F. Wickmann 1, A. Antal 1, W. Paulus 1
  • 1Göttingen

Background and purpose: Patients with menstrual migraine often suffer from psychological strain. Preventive therapy is indicated in about a third of patients, and although a broad range of pharmaceutical option exists, there is an increasing interest concerning non-pharmaceutical alternatives.

According to this, the repetitive cathodal transcranial direct current stimulation (rc-tDCS) of the visual cortex as non-invasive brain stimulation might be a therapeutic alternative. The present study aimed to explore the efficacy of rc-tDCS as a prophylactic treatment in migraineurs and to decrease the frequency or shorten the duration of attacks by decreasing the excitability of the visual cortex.

Methods: Six migraineurs participated in this double-blind and randomized study. For three cycles of menstruation, we applied cathodal tDCS (2mA) to the visual cortex of the patients in five consecutive sessions for twenty minutes one to five days before the first day of their menstruation. Three patients received tDCS and three participants sham stimulation. Visual cortex excitability was monitored by measuring the phosphene threshold (PT). PT was determined before and after a stimulation session. In addition, depressive symptomatic was measured by the Beck Depression Inventory (BDI) and the health-related quality by SF-36.

Results: (Verum Stimulation) One patient did not have any migraine attacks during the whole three months of stimulation period; her PT increased about 64%. Two patients observed a decrease of intensity and duration of attacks; their PT increased about 32% and 6%, respectively. They did not detect an improvement of health-related quality of life or depressive symptomatic. However, they noticed an improvement of power of concentration. (Sham stimulation) One of three patients noticed one cycle without migraine. The other patients did not observe any changes of migraine during the cycles of stimulation. The PT of one patient decreased about 11%. Apart from this, the PT did not increase and the depressive symptomatic or the health-related quality of life did not change post-stimulation.

Conclusion: The results imply that the sham stimulation could not influence the PT. In parallel to the elevation of the PT, the frequency of attacks during menstruation decreased. It is essential to investigate higher number of patients to verify the differences between the stimulation and the sham stimulation conditions. Further studies should explore the duration of the after-effects of the stimulation.