Background Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered. Objective To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A). Methods Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study. A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine. Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once. Results There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS ( P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS ( P < 0.001). Conclusion Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.

中文翻译：

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重复经颅磁刺激作为偏头痛的预防性治疗

背景经颅磁刺激 (TMS) 的临床应用在头痛疾病的治疗中显示出有希望的结果，偏头痛是最常见的一种。目的 评估低频重复经颅磁刺激作为偏头痛（有先兆和无先兆）预防性治疗的作用，并将结果与​​炎症生物标志物（神经激肽 A）的血清水平相关联。方法 40例年龄在15～55岁的偏头痛患者（无先兆偏头痛30例，有先兆偏头痛10例）和20例年龄、性别与患者组相匹配的表观健康者纳入研究。间歇期连续五天对所有患者应用低频 (1 Hz) rTMS 协议。根据 TMS 治疗前 4 周和治疗后 4 周的基本诊断头痛日记，使用视觉模拟量表评估疼痛强度、发作频率和持续时间以及患者作为无效治疗服用的药丸数量。此外，偏头痛残疾评估量表（MIDAS）用于评估偏头痛引起的残疾的严重程度和程度。神经激肽A血清水平的测定采用ELISA对所有患者TMS前后和对照组进行一次。结果 rTMS 后疼痛强度、偏头痛发作的频率和持续时间、偏头痛残疾评分和作为中止治疗的药丸数量显着减少（ P < 0.001）。还，rTMS后患者血清神经激肽A水平显着降低（ P < 0.001）。结论 低频 rTMS 是有先兆和无先兆偏头痛的有效预防性治疗方法。