Prophylactic treatment with repetitive cathodal transcranial direct current stimulation of the visual cortex decrease the number of attacks in patients with menstrual migraine

Background and Purpose: Differences between people with and without migraine on visual perception an cortical excitability have been attributed to abnormal cortical processing due to the disease between and during attacks. Preventive therapy is indicated in about third of patients, and although a broad range of pharmaceutical option exists, there is an increasing interest with regard to non-pharmaceutical alternatives. According to this, the application of repetitive cathodal transcranial direct current stimulation (rc-tDCS) of the visual cortex (V1) as a non-invasive brain stimulation method might be a therapeutic option by decreasing the excitability of the cortex. This study aimed to explore the efficacy of 5 days rc-tDCS as a prophylactic treatment in migraineurs.

Methods: 16 patients participated in this double-blind and randomized study. For 3 cycles of menstruation, we applied cathodal or sham tDCS (2mA) to the V1 of the patients in 5 consecutive sessions for 20 minutes 1 – 5 days before the first day of their menstruation. The frequency and duration of attacks and the intensity of pain and related migraine symptoms were recoded 3 months before, during and 3 months post-treatment. V1 excitability was monitored by measuring the phosphene threshold (PT). PT was determined before and after a stimulation sessions. In addition, quality of life and depressive symptomatic was measured by the SF-36 questionnaire and the Beck Depression Inventory (BDI).

Results: The number of migraine attacks significantly decreased in patients treated by rctDCS in comparison to the sham group and parallel the increase of PTs were observed.

Conclusion: Our results suggest that the application of rc-tDCS over the V1 might be an effective prophylactic therapy in menstruation dependent migraine.