LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany.
LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany; Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Eur J Paediatr Neurol. 2022 Jul;39:40-48. doi: 10.1016/j.ejpn.2022.04.010. Epub 2022 May 6.
Repetitive neuromuscular magnetic stimulation (rNMS) was previously applied in adult patients with episodic migraine, showing beneficial effects on headache characteristics, high safety, and convincing satisfaction. This study aims to assess rNMS as a personalized intervention in pediatric headache.
Retrospective chart review including patients with migraine, TTH, mixed type headache, or PTH, who had received at least one test rNMS session targeting the upper trapezius muscles (UTM).
33 patients (13.9 ± 2.5 years; 61% females) were included in the primary analysis, resulting in a total of 182 rNMS sessions. 43 adverse events were documented for 40 of those sessions (22%). Most common side effects were tingling (32.6%), muscle sore (25.5%), shoulder (9.3%) and back pain (9.3%). Secondly, in patients (n = 20) undergoing the intervention, headache frequency (p = 0.017) and minimum and maximum intensities (p = 0.017; p = 0.023) significantly decreased from baseline to 3-month after intervention. 11 patients (44%) were classified as ≥25% responders, with 7 patients (28%) experiencing a ≥75% reduction of headache days. After 73% of interventions, patients reported rNMS helped very well or well. A majority of patients would repeat (88.5%) and recommend rNMS (96.2%) to other patients.
rNMS seems to meet the criteria of safety, feasibility, and acceptance among children and adolescents with three age-typical headache disorders. A significant reduction in headache frequency and intensity during a 3 months follow-up was documented. Larger, prospective, randomized, sham-controlled studies are urgently needed to confirm if rNMS may become a new valuable non-invasive, non-pharmacological treatment option for pediatric headache disorders.
重复神经肌肉磁刺激（rNMS）以前曾应用于发作性偏头痛的成年患者，对头痛特征具有有益的影响，安全性高，满意度高。本研究旨在评估 rNMS 作为儿科头痛的个性化干预措施。
回顾性图表审查包括接受至少一次针对上斜方肌（UTM）的测试 rNMS 治疗的偏头痛、TTH、混合性头痛或 PTH 患者。
33 名患者（13.9±2.5 岁；61%为女性）被纳入主要分析，共进行了 182 次 rNMS 治疗。有 40 次治疗记录了 43 次不良反应（22%）。最常见的副作用是刺痛（32.6%）、肌肉酸痛（25.5%）、肩部（9.3%）和背部疼痛（9.3%）。其次，在接受干预的 20 名患者中，头痛频率（p=0.017）和最小和最大强度（p=0.017；p=0.023）从基线到干预后 3 个月显著降低。11 名患者（44%）被归类为≥25%的应答者，其中 7 名患者（28%）头痛天数减少≥75%。88.5%的患者在 73%的治疗后报告 rNMS 非常有效或有效。大多数患者会重复（88.5%）并向其他患者推荐 rNMS（96.2%）。
rNMS 似乎满足了安全性、可行性和接受性的标准，适用于三种典型年龄的头痛障碍儿童和青少年。在 3 个月的随访期间，头痛频率和强度显著降低。迫切需要更大规模、前瞻性、随机、假对照研究来证实 rNMS 是否可能成为治疗儿科头痛障碍的新的有价值的非侵入性、非药物治疗选择。
