Department of Neurology, Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Neurotherapeutics. 2010 Apr;7(2):204-12. doi: 10.1016/j.nurt.2010.03.002.
Transcranial magnetic stimulation (TMS) is a diagnostic and therapeutic modality that is being developed as both an acute and preventive treatment for migraine. TMS delivers a fluctuating magnetic field from the scalp surface to induce current in the subjacent cortex. Magnetic pulses are delivered one at a time in single-pulse TMS (sTMS) or as a train of pulses in repetitive TMS (rTMS). For most of its 30-year history, TMS has been delivered in clinical and research settings using large tabletop devices. Based on the theory that sTMS may disrupt cortical spreading depression, sTMS has been studied and shown to be effective as an acute treatment for migraine with aura. Subsequent work in animal models confirms that sTMS disrupts cortical spreading depression. To make outpatient self-treatment possible, a portable device has been developed for acute treatment of migraine with aura. Based on the theory that rTMS alters brain excitability and neurotransmitter activity, rTMS has been studied as a preventive migraine treatment. A small body of evidence suggests that rTMS may have a role, but further studies are needed. In this review, we summarize the data on TMS as a treatment of migraine, and we suggest directions for future research.
经颅磁刺激（TMS）是一种诊断和治疗方式，正在被开发为偏头痛的急性和预防性治疗手段。TMS 通过头皮表面传递变化的磁场，在下方皮质中产生电流。磁脉冲在单次脉冲 TMS（sTMS）中一次传递一个，或在重复 TMS（rTMS）中作为脉冲串传递。在其 30 年的历史中，TMS 主要在临床和研究环境中使用大型台式设备进行传输。基于 sTMS 可能会破坏皮质扩散性抑制的理论，已经对 sTMS 进行了研究，并证明其作为偏头痛伴先兆的急性治疗方法是有效的。动物模型中的后续工作证实，sTMS 可破坏皮质扩散性抑制。为了实现门诊自我治疗，已经开发出一种便携式设备用于偏头痛伴先兆的急性治疗。基于 rTMS 改变大脑兴奋性和神经递质活性的理论，已经对 rTMS 作为预防性偏头痛治疗进行了研究。有少量证据表明 rTMS 可能具有一定作用，但还需要进一步的研究。在这篇综述中，我们总结了 TMS 作为偏头痛治疗方法的数据，并提出了未来研究的方向。
