Transcranial magnetic stimulation for migraine: clinical effects

The objective was to assess the impact of transcranial magnetic stimulation (TMS) on pain and the autonomic nervous system (ANS) in migraine. Forty-two people [mean age 41.43+/-11.69 (SD) years, 36 females] were randomised into high vs. low TMS stimulation groups and received 2 brief pulses of TMS. Thirty-three (33/42) individuals had heart-rate variability assessed, before and after stimulation. No group effects were found. Pain decreased by 75%; 32% of people after 1 treatment reported no headache after 24 h. Mean heart rate decreased from 79.05+/-10.27 to 72.89+/-11.35 beats/min. The low-frequency (LF) and the high-frequency (HF) areas derived from power spectral analyses increased [mean 6522+/-1277 to 8315+/-1009 beats/min(2) (LF) (p=0.001) and mean 5600+/-1568 to 8755+/-3071 beats/min(2) (HF) (p=0.001)]. The LF:HF ratio decreased from mean 1.31+/-0.51 to 1.13+/-0.48 (NS). TMS produces immediate, sustained reductions in pain and modification of the ANS.