Objective The aim of the study was to examine the prophylactic role of repetitive transcranial magnetic stimulation (rTMS) on the frequency, and severity of migraine attacks in episodic migraineurs who failed medical treatment. Methods A randomized double-blinded placebo-controlled study was designed to assess the effect of 5 Hz rTMS applied over the left dorsolateral prefrontal cortex (LDLPFC ) in 33 migraineurs. Patients were followed up for 1 month before receiving rTMS, and for another month after the sessions by a headache diary. The primary outcome measure was the achievement of 50% reduction in the number of migraine attacks. Secondary outcome measures included migraine days, assessment of migraine attack severity, disability by HIT-6, and side-effects to the procedure. Results The study revealed that 69.2% of the active treatment group achieved 50% or more reduction in the number of migraine attacks versus 25% of cases in the control group ( p = 0.02). The absolute number of migraine attacks was reduced by 3.1 vs 1.5 in the active and control group, respectively. The number of cases with severe HIT-6 scores was reduced by 46.2% in active treatment group versus a 7.1% reduction in the control group ( p = 0.02). Conclusion High-frequency rTMS applied to LDLPFC can reduce the number of migraine attacks by 50% or more in almost 70% of a sample of episodic migraineurs with a concomitant decrease in functional disability. Trial registration ClinicalTrials.gov , Identifier: NCT04031781. Registered 23 July 2019—retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT04031781?term=Migraine+Prophylaxis&recrs=ce&type=Intr&cond=Migraine&rank=9

中文翻译：

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左前额叶经颅磁刺激在预防发作性偏头痛中的作用

目的 本研究的目的是检查重复经颅磁刺激 (rTMS) 对药物治疗失败的偶发性偏头痛患者的偏头痛发作频率和严重程度的预防作用。方法 一项随机双盲安慰剂对照研究旨在评估 5 Hz rTMS 对 33 名偏头痛患者的左背外侧前额叶皮层 (LDLPFC) 的影响。患者在接受 rTMS 前随访 1 个月，并在治疗后通过头痛日记再随访 1 个月。主要结果指标是偏头痛发作次数减少 50%。次要结果测量包括偏头痛天数、偏头痛发作严重程度的评估、HIT-6 的残疾以及手术的副作用。结果研究表明，69. 与对照组中 25% 的病例相比，2% 的积极治疗组的偏头痛发作次数减少了 50% 或更多 (p = 0.02)。主动组和对照组的偏头痛发作绝对次数分别减少了 3.1 次和 1.5 次。积极治疗组的严重 HIT-6 评分病例数减少了 46.2%，而对照组减少了 7.1%（p = 0.02）。结论 应用于 LDLPFC 的高频 rTMS 可以将几乎 70% 的偶发性偏头痛患者样本中的偏头痛发作次数减少 50% 或更多，同时功能障碍也随之减少。试验注册 ClinicalTrials.gov，标识符：NCT04031781。2019 年 7 月 23 日注册——追溯注册于 https://clinicaltrials.gov/ct2/show/NCT04031781?term=Migraine+Prophylaxis&recrs=ce&type=Intr&