Repetitive transcranial magnetic stimulation in chronic tension-type headache: A pilot study

Background & objectives: Tension-type headache (TTH) is the most common type of primary headache disorder. Its chronic form is often the most ignored and challenging to treat. Transcranial magnetic stimulation (TMS) is a novel technique in the treatment of chronic pain. The aim of this pilot stu...

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Bibliographic Details
Published in:Indian journal of medical research (New Delhi, India : 1994) India : 1994), 2019-07, Vol.150 (1), p.73-80
Main Authors: Mattoo, Bhawna, Tanwar, Suman, Bhatia, Rohit, Tripathi, Manjari, Bhatia, Renu
Format: Article
Language:English
Subjects:
Adult
Analgesics
Anxiety
Care and treatment
Chronic pain
Chronic Pain - pathology
Chronic Pain - therapy
Female
Fibromyalgia
Headache
Headaches
Humans
Laboratories
Magnetic brain stimulation
Male
Middle Aged
NMR
Nuclear magnetic resonance
Original
Pain
Pain management
Pain Management - methods
Pain Measurement
Patient outcomes
Patients
Pilot Projects
Prefrontal Cortex - physiopathology
Prefrontal Cortex - radiation effects
Quality of Life
Questionnaires
Spinal cord
Substance abuse treatment
Tension headache
Tension-Type Headache - physiopathology
Tension-Type Headache - therapy
Transcranial Magnetic Stimulation
Treatment Outcome
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Summary:Background & objectives: Tension-type headache (TTH) is the most common type of primary headache disorder. Its chronic form is often the most ignored and challenging to treat. Transcranial magnetic stimulation (TMS) is a novel technique in the treatment of chronic pain. The aim of this pilot study was to explore the effect of low-frequency repetitive TMS (rTMS) on pain status in chronic TTH (CTTH) by subjective and objective pain assessment. Methods: Patients (n=30) diagnosed with CTTH were randomized into rTMS (n=15) and placebo (n=15) groups in this study. Pre-intervention detailed history of patients was taken. Numerical Rating Scale (NRS) for Pain and questionnaires [Headache Impact Test-6 (HIT-6), McGill Pain Questionnaire, Pain Beliefs Questionnaire, Coping Strategies Questionnaire, State-Trait Anxiety Inventory Test, Hamilton Rating Scale for Depression and WHO-Quality of Life Questionnaire-Brief version] were filled, and objective assessments such as nociceptive flexion reflex (NFR) and conditioned pain modulation were done. The tests were repeated after 20 sessions (5 days/week). In the rTMS group, 1200 pulses in eight trains of 150 pulses each were given at 1Hz over the right dorsolateral prefrontal cortex (RDLPFC). In the placebo group, the rTMS coil was placed such that magnetic stimulation did not reach the cortex. Results: The NRS score decreased significantly (P
ISSN:0971-5916
DOI:10.4103/ijmr.IJMR_97_18