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Magnets for migraine : transcranial magnetic stimulation

Modulating the electrical activity of the brain can be done with devices. We call those neuromodulation devices. One such therapy is single pulse transcranial magnetic stimulator (sTMS), now approved in the USA for the acute and preventive treatment [1] of migraine [2] in adults.  

How does sTMS work for treating migraine headache?

sTMS targets the cortex, the outer part of the brain, using strong magnetic fields that induce a local electrical current. This has been shown in studies to inhibit cortical spreading depression, the electrical wave causing the migraine aura [3]. It is also thought to change the firing of connections between the cortex and deep centers in the brain that help process sensation and pain. This can help reduce the excitability of the pain networks that plays a role in generating migraine.  

Is sTMS effective to treat the migraine attack? 

In a study on migraine with aura [4] (See this post [5]), patients tried sTMS or a fake pulse (placebo). The real sTMS lead to a pain-free state at 2h in 40% of patients compared to 22% of patients for the placebo. Side effects were minor and similar in both groups. This suggests that sTMS could be used to treat an attack of migraine with aura. No studies are available for migraines without aura.

eneura device

Is stMS effective for migraine prevention? 

sTMS can be used both as prevention (4 pulses twice a day), or as an acute abortive (3 pulses as needed).  In a study funded by eNeura, patients had a reduction of 2.8  headache days from their baseline of 9.1 days. No serious side effects occurred during the study, however some people experienced light-headedness, dizziness [6], tingling, ringing in the ears, or the occasional headache.   

Is sTMS right for me?

People who have seizures or electrical implanted devices in the head, neck, or upper body should not use this treatment.

How much does it cost? Where can I get a device?

The cost is $750 USD every 3 months as part of a subscription service. This is currently available only in the USA, however there are plans to expand to Canadian markets eventually.

Summary

Transcranial Magnetic Stimulation has been tested with favorable results as a migraine therapy. The device is sadly not available in Canada but it is an interesting option to be aware of. Some people may have access to it in the US. 

REFERENCES

Lan L, Zhang X, Li X, Rong X, Peng Y. The efficacy of transcranial magnetic stimulation on migraine: a meta-analysis of randomized controlled trails. J Headache Pain. 2017;18(1):86.

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