Renner Tabea, Sollmann Nico, Trepte-Freisleder Florian, Albers Lucia, Mathonia Nina M, Bonfert Michaela V, König Helene, Klose Birgit, Krieg Sandro M, Heinen Florian, Gerstl Lucia, Landgraf Mirjam N
Department of Pediatric Neurology and Developmental Medicine, LMU Center for Children With Medical Complexity, Dr. von Hauner Children's Hospital, LMU-University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.
Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Front Neurol. 2019 Jul 16;10:738. doi: 10.3389/fneur.2019.00738. eCollection 2019.
Repetitive peripheral magnetic stimulation (rPMS) has been successfully applied recently in migraineurs to alleviate migraine symptoms. Symptom relief has been achieved by stimulating myofascial trigger points (mTrPs) of the trapezius muscles, which are considered part of the trigemino-cervical complex (TCC). However, effects on musculature have not been assessed in detail, and the specificity of effects to muscles considered part of the TCC yet has to be elucidated. Against this background, this study presents the setup of rPMS in migraine and evaluates effects on skeletal musculature. Thirty-seven adults (mean age: 25.0 ± 4.1 years, 36 females) suffering from migraine and presenting mTrPs according to physical examination underwent rPMS either to mTrPs in the trapezius muscles (considered part of the TCC; = 19) or deltoid muscles (considered not part of the TCC; = 18) during six sessions over the course of 2 weeks. Standardized questionnaires were filled in to assess any adverse events and experience with rPMS as well as satisfaction and benefits from stimulation. Algometry was performed to evaluate changes in pressure pain thresholds (PPTs). All stimulation sessions were successfully performed without adverse events, with 84.2% of subjects of the trapezius group and 94.4% of subjects of the deltoid group describing rPMS as comfortable ( = 0.736). Muscular pain or tension improved in 73.7% of subjects of the trapezius group and in 61.1% of subjects of the deltoid group ( = 0.077). PPTs of the trapezius muscles clearly increased from the first to the last stimulation sessions-regardless of the stimulated muscle (rPMS to the trapezius or deltoid muscles). However, depending on the examined muscles the increase of PPTs differed significantly (subjects with stimulation of trapezius muscles: = 0.021; subjects with stimulation of deltoid muscles: = 0.080). rPMS is a comfortable method in migraineurs that can improve local muscular pain or tension. Furthermore, it is able to increase directly and indirectly the PPTs of the trapezius muscles (considered part of the TCC) when applied over mTrPs, supporting the role of the TCC in migraineurs.
重复经颅磁刺激（rPMS）最近已成功应用于偏头痛患者以缓解偏头痛症状。通过刺激斜方肌的肌筋膜触发点（mTrP）实现了症状缓解，这些触发点被认为是三叉神经 - 颈复合体（TCC）的一部分。然而，尚未详细评估其对肌肉组织的影响，对被认为是TCC一部分的肌肉的效应特异性仍有待阐明。在此背景下，本研究介绍了偏头痛患者中rPMS的设置，并评估其对骨骼肌组织的影响。37名患有偏头痛且根据体格检查存在mTrP的成年人（平均年龄：25.0±4.1岁，36名女性）在2周内进行了6次治疗，分别对斜方肌的mTrP（被认为是TCC的一部分；n = 19）或三角肌的mTrP（被认为不是TCC的一部分；n = 18）进行rPMS。填写标准化问卷以评估任何不良事件、rPMS体验以及刺激带来的满意度和益处。采用压力痛觉阈值（PPT）测量法评估变化。所有刺激疗程均成功完成，无不良事件发生，斜方肌组84.2%的受试者和三角肌组94.4%的受试者表示rPMS感觉舒适（P = 0.736）。斜方肌组73.7%的受试者和三角肌组61.1%的受试者肌肉疼痛或紧张情况有所改善（P = 0.077）。无论刺激的是哪块肌肉（对斜方肌或三角肌进行rPMS），从第一次到最后一次刺激疗程，斜方肌的PPT均明显升高。然而，根据所检查的肌肉不同，PPT的升高存在显著差异（刺激斜方肌的受试者：P = 0.021；刺激三角肌的受试者：P = 0.080）。rPMS对偏头痛患者是一种舒适的方法，可改善局部肌肉疼痛或紧张。此外，当应用于mTrP时，它能够直接和间接增加斜方肌（被认为是TCC的一部分）的PPT，支持TCC在偏头痛患者中的作用。
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