Misra Usha K, Kalita Jayantee, Bhoi Sanjeev K
Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Neurol Res. 2012 Jul;34(6):547-51. doi: 10.1179/1743132812Y.0000000045. Epub 2012 Jun 20.
To evaluate the effect of high rate repetitive transcranial magnetic stimulation (rTMS) in migraine prophylaxis in medically refractory patients.
Migraine patients above 15 years of age, having more than 7 attacks/month and refractory to at least two prophylactic drugs were included. The patients were evaluated for migraine frequency, severity, functional disability, number of rescue medications and migraine index. Three sessions of alternate day 10 Hz rTMS comprising of 600 pulses in 10 trains were delivered to left frontal cortex. The response was evaluated at the end of session and weekly for 4 weeks.
Fifty-one patients aged 16-61 years and 45 females were treated. Fifty (98%) patients had more than 50% reduction of headache frequency at the end and 1 week after rTMS and the improvement persisted till the fourth week in 80.4% patients. The headache frequency, severity, functional disability, migraine index, and rescue medications significantly reduced at all time points, but the maximum benefit was observed in the first 2 weeks. There were no serious adverse events.
High rate rTMS in left frontal cortex is effective and well tolerated for migraine prophylaxis.
评估高频重复经颅磁刺激（rTMS）对药物难治性偏头痛患者预防偏头痛的效果。
纳入年龄在15岁以上、每月发作超过7次且对至少两种预防性药物难治的偏头痛患者。对患者的偏头痛发作频率、严重程度、功能障碍、急救药物数量和偏头痛指数进行评估。对左侧额叶皮质进行3次隔日10Hz的rTMS治疗，每次治疗包含10组，每组600个脉冲。在每次治疗结束时及之后4周每周对反应进行评估。
共治疗51例年龄在16 - 61岁的患者，其中45例为女性。50例（98%）患者在rTMS治疗结束时及结束后1周头痛频率降低超过50%，80.4%的患者改善持续至第4周。在所有时间点，头痛频率、严重程度、功能障碍、偏头痛指数和急救药物数量均显著降低，但最大获益出现在前2周。未出现严重不良事件。
左侧额叶皮质高频rTMS对偏头痛预防有效且耐受性良好。
