Mastria Giulio, Viganò Alessandro, Corrado Alessandra, Mancini Valentina, Pirillo Cristina, Badini Simone, Petolicchio Barbara, Toscano Massimiliano, Altieri Marta, Delle Chiaie Roberto, Di Piero Vittorio
Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.
My Space Lab, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland.
Front Neurol. 2021 May 13;12:654900. doi: 10.3389/fneur.2021.654900. eCollection 2021.
Chronic migraine (CM) is often complicated by medication overuse headache (MOH) and psychiatric comorbidities that may influence the clinical outcome. This study aimed to investigate the relationship between psychiatric comorbidities and the effect of transcranial direct current stimulation (tDCS) in patients with CM with or without MOH. We recruited 16 consecutive CM patients who had an unsatisfactory response to at least three pharmacological preventive therapies. They were treated with anodal right-prefrontal and cathodal occipital tDCS (intensity: 2 mA, time: 20 min) three times per week for 4 weeks. All patients underwent a psychopathological assessment before and after treatment, and five of them were diagnosed with bipolar disorder (BD). After treatment, all the patients showed a significant decrease of severe and overall headache days per month. Despite having a higher migraine burden at baseline, patients with CM and BD showed a significantly greater reduction of severe headaches and psychiatric symptoms. Overall, tDCS seems to be effective in the treatment of CM patients with a poor response to different classes of pharmacological therapies, whereas BD status positively influences the response of migraineurs to tDCS.
慢性偏头痛（CM）常并发药物过度使用性头痛（MOH）以及可能影响临床结局的精神共病。本研究旨在调查精神共病与经颅直流电刺激（tDCS）对合并或不合并MOH的CM患者疗效之间的关系。我们连续招募了16例对至少三种药物预防性治疗反应不佳的CM患者。他们接受每周三次、每次20分钟的阳极右侧前额叶和阴极枕叶tDCS治疗（强度：2 mA），持续4周。所有患者在治疗前后均接受了精神病理学评估，其中5例被诊断为双相情感障碍（BD）。治疗后，所有患者每月的重度头痛天数和总头痛天数均显著减少。尽管CM合并BD的患者在基线时偏头痛负担更高，但他们的重度头痛和精神症状减轻得更为显著。总体而言，tDCS似乎对不同类别药物治疗反应不佳的CM患者有效，而BD状态对偏头痛患者对tDCS的反应有积极影响。
