Department of Pediatric Neurology and Developmental Medicine and 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.
Sci Rep. 2020 Apr 6;10(1):5954. doi: 10.1038/s41598-020-62701-9.
Migraine is a burdensome disease with an especially high prevalence in women between the age of 15 and 49 years. Non-pharmacological, non-invasive therapeutic methods to control symptoms are increasingly in demand to complement a multimodal intervention approach in migraine. Thirty-seven subjects (age: 25.0 ± 4.1 years; 36 females) diagnosed with high-frequency episodic migraine who presented at least one active myofascial trigger point (mTrP) in the trapezius muscles and at least one latent mTrP in the deltoid muscles bilaterally prospectively underwent six sessions of repetitive peripheral magnetic stimulation (rPMS) over two weeks. Patients were randomly assigned to receive rPMS applied to the mTrPs of the trapezius (n = 19) or deltoid muscles (n = 18). Whereas the trapezius muscle is supposed to be part of the trigemino-cervical complex (TCC) and, thus, involved in the pathophysiology of migraine, the deltoid muscle was not expected to interfere with the TCC and was therefore chosen as a control stimulation site. The headache calendar of the German Migraine and Headache Society (DMKG) as well as the Migraine Disability Assessment (MIDAS) questionnaire were used to evaluate stimulation-related effects. Frequency of headache days decreased significantly in both the trapezius and the deltoid group after six sessions of rPMS (trapezius group: p = 0.005; deltoid group: p = 0.003). The MIDAS score decreased significantly from 29 to 13 points (p = 0.0004) in the trapezius and from 31 to 15 points (p = 0.002) in the deltoid group. Thus, rPMS applied to mTrPs of neck and shoulder muscles offers a promising approach to alleviate headache frequency and symptom burden. Future clinical trials are needed to examine more profoundly these effects, preferably using a sham-controlled setting.
偏头痛是一种负担沉重的疾病,15 至 49 岁的女性患病率尤其高。为了补充偏头痛的多模式干预方法,人们越来越需要非药物、非侵入性的治疗方法来控制症状。37 名(年龄:25.0±4.1 岁;36 名女性)被诊断为高频发作性偏头痛的患者,双侧三角肌至少有一个活跃的肌筋膜触发点(mTrP)和至少一个潜伏的 mTrP,前瞻性地接受了为期两周的六次重复外周磁刺激(rPMS)治疗。患者随机分配接受 rPMS 应用于斜方肌(n=19)或三角肌(n=18)的 mTrP。虽然斜方肌被认为是三叉颈复合体(TCC)的一部分,因此参与偏头痛的病理生理学,但三角肌预计不会干扰 TCC,因此被选为对照刺激部位。德国偏头痛和头痛协会(DMKG)头痛日历和偏头痛残疾评估(MIDAS)问卷用于评估刺激相关的效果。六次 rPMS 治疗后,斜方肌和三角肌组的头痛天数均显著减少(斜方肌组:p=0.005;三角肌组:p=0.003)。MIDAS 评分从 29 分降至 13 分(p=0.0004),斜方肌组从 31 分降至 15 分(p=0.002)。因此,rPMS 应用于颈部和肩部肌肉的 mTrP 提供了一种有前途的方法,可以减轻头痛频率和症状负担。需要进一步的临床试验来更深入地研究这些效果,最好使用假对照设置。
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