R ES E A R C H A R T I C L E Open Access
The efficacy of transcranial magnetic
stimulation on migraine: a meta-analysis of
randomized controlled trails
, Xiaoni Zhang
, Xiangpen Li
, Xiaoming Rong
and Ying Peng
Objectives: As a non-invasive therapy, whether transcranial magnetic stimulation (TMS) is effective on migraine.
This article was aimed to assess the efficacy of TMS on migraine based on randomized controlled trails (RCTs).
Methods: We searched PubMed, Embase and Cochrane Library electronic databases for published studies which
compared TMS group with sham group, conducted a meta-analysis of all RCTs.
Results: Five studies, consisting of 313 migraine patients, were identified. Single-pulse transcranial magnetic stimulation is
effective for the acute treatment of migraine with aura after the first attack (p = 0.02). And, the efficacy of TMS on chronic
migraine was not significant (OR 2.93; 95% CI 0.71–12.15; p =0.14).
Conclusions: TMS is effective for migraine based on the studies included in the article.
Keywords: Migraine, Transcranial magnetic stimulation, Randomized control trail
Recently, the incidence of migraine is gradually rising
and becoming one of the most common nervous system
diseases in the world . According to ICHD-3 (beta
version), migraine is divided into migraine without aura,
migraine with aura, chronic migraine, complications of
migraine, probable migraine and episodic syndromes
that may be associated with migraine. Particularly,
chronic migraine cause serious damage in the quality of
life. However, the effect of the drug therapies, include
acute therapies (non-steroidal anti-inflammatory drugs,
ergotamine preparations and triptans) and preventive
therapies (β-blockers, anticonvulsants, tricyclic antide-
pressants and calcium channel modulators), are not sig-
nificantly improved the clinical symptoms.
Transcranial magnetic stimulation (TMS), which is a
magnetic field created by an electrical current through a
coil wrapped around the scalp or skull. The types of
TMS include single-pulse TMS, pair-pulses TMS and
repetitive TMS. In neurophysiology, TMS can measure
neural conduction, facilitate or inhibit the electrical ac-
tivity of cerebral cortex . TMS is a noninvasive tech-
nology and the first transcranial magnetic stimulator
was introduced to the world in 1984–1985 . Never-
theless, using TMS for a therapy was firstly reported on
drug-resistant depressed patients in 1996 . After
30 years later, TMS now can be applied for a diagnostic
therapy in many diseases including multiple sclerosis,
movement disorder, stroke, epilepsy and so on [5, 6].
Meanwhile, TMS also can be used for a therapy. There
has been reported a series of diseases covering psychi-
atric disorders (depression, acute mania, schizophrenia,
bipolar disease, panic disorder, post-traumatic stress
disorder, substance abuse) and neurologic disorders
(Parkinson’s disease, dystonia, tinnitus, epilepsy, stroke)
improved by TMS [7–26]. Furthermore, single-pulse and
paired-pulse/double-coil TMS are safety for normal
human subjects and patients who suffer from migraine
[2, 27]. However, there is less randomized control trails
(RCTs) to identify the efficacy of TMS in migraine at
present. Recently, there are some papers reviewed the effect
of TMS for migraine [28, 29], but lack a meta-analysis.
* Correspondence: email@example.com
Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen
University, Number 33, Yingfeng Road, Haizhu District, Guangzhou 510288,
Full list of author information is available at the end of the article
The Journal of Headache
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
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Lan et al. The Journal of Headache and Pain (2017) 18:86