Brighina Filippo, Raieli Vincenzo, Messina Luca Maria, Santangelo Giuseppe, Puma Domenico, Drago Flavia, Rocchitelli Lucia, Vanadia Francesca, Giglia Giuseppe, Mangano Salvatore
Dipartimento di Biomedicina, Neuroscienze and Diagnostica Avanzata (BiND), University of Palermo, Palermo, Italy.
ARNAS Ospedali Civico Di Cristina Benfratelli, Palermo, Italy.
Front Neurol. 2019 Apr 12;10:364. doi: 10.3389/fneur.2019.00364. eCollection 2019.
Pediatric migraine remains still a challenge for the headache specialists as concerns both diagnostic and therapeutic aspects. The less ability of children to describe the exact features of their migraines and the lack of reliable biomarker for migraine contribute to complicate the diagnostic process. Therefore, there's need for new effective tools for supporting diagnostic and therapeutic approach in children with migraine. Recently, promising results have been obtained in adult headache by means of application of neurostimulation techniques both for investigating pathophysiological mechanisms and also for therapeutical applications. Non-invasive brain stimulation (NIBS) techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) indeed proved to be generally safe and showing also some evidence of efficacy particularly for the symptomatic treatment. On such basis, in the last years increasing interest is rising in scientific pediatric community to evaluate the potential of such approaches for treatment pediatric headaches, particularly in migraine, even if the evidence provided is still very poor. Here we present a perspective for application of TMS and tDCS technique in children migraine principally based on evidence coming by studies in adults.
儿童偏头痛在诊断和治疗方面仍然是头痛专家面临的一项挑战。儿童描述偏头痛确切特征的能力较弱以及缺乏可靠的偏头痛生物标志物，使得诊断过程变得复杂。因此，需要新的有效工具来支持儿童偏头痛的诊断和治疗方法。最近，通过应用神经刺激技术来研究病理生理机制以及用于治疗，在成人头痛方面取得了有前景的结果。非侵入性脑刺激（NIBS）技术，如经颅磁刺激（TMS）和经颅直流电刺激（tDCS），确实被证明总体上是安全的，并且也显示出一些疗效证据，特别是在对症治疗方面。基于此，在过去几年中，科学的儿科界越来越关注评估这些方法治疗儿童头痛，特别是偏头痛的潜力，尽管所提供的证据仍然非常有限。在此，我们主要基于成人研究的证据，提出TMS和tDCS技术在儿童偏头痛中的应用前景。
