Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials

Yu Chen Cheng; Bing Yan Zeng; Chao Ming Hung; Kuan Pin Su; Yi Cheng Wu; Yu Kang Tu; Pao Yen Lin; Brendon Stubbs; Andre F. Carvalho; Chih Sung Liang; Tien Yu Chen; Chih Wei Hsu; Andre R. Brunoni; Mein Woei Suen; Yow Ling Shiue; Ping Tao Tseng; Ming Kung Wu; Cheng Ta Li

doi:10.1186/s10194-022-01401-3

Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials

Yu Chen Cheng, Bing Yan Zeng, Chao Ming Hung, Kuan Pin Su, Yi Cheng Wu, Yu Kang Tu, Pao Yen Lin, Brendon Stubbs, Andre F. Carvalho, Chih Sung Liang, Tien Yu Chen, Chih Wei Hsu, Andre R. Brunoni, Mein Woei Suen, Yow Ling Shiue, Ping Tao Tseng^*, Ming Kung Wu^*, Cheng Ta Li^*

^*Corresponding author for this work

School of Medicine

Research output: Contribution to journal › Journal Article › peer-review

19 Scopus citations

Abstract

Background: Current pharmacologic prophylactic strategies for migraine have exhibited limited efficacy, with response rates as low as 40%–50%. In addition to the limited efficacy, the acceptability of those pharmacologic prophylactic strategies were unacceptable. Although noninvasive brain/nerve stimulation strategies may be effective, the evidence has been inconsistent. The aim of this network meta-analysis (NMA) was to compare strategies of noninvasive brain/nerve stimulation for migraine prophylaxis with respect to their effectiveness and acceptability. Methods: The PubMed, Embase, ScienceDirect, ProQuest, ClinicalTrials.gov, ClinicalKey, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov databases were systematically searched to date of June 4th, 2021 for randomized controlled trials (RCTs). Patients with diagnosis of migraine, either episodic migraine or chronic migraine, were included. All NMA procedures were conducted under the frequentist model. Results: Nineteen RCTs were included (N = 1493; mean age = 38.2 years; 82.0% women). We determined that the high frequency repetitive transcranial magnetic stimulation (rTMS) over C3 yielded the most decreased monthly migraine days among all the interventions [mean difference = − 8.70 days, 95% confidence intervals (95%CIs): − 14.45 to − 2.95 compared to sham/control groups]. Only alternating frequency (2/100 Hz) transcutaneous occipital nerve stimulation (tONS) over the Oz (RR = 0.36, 95%CIs: 0.16 to 0.82) yielded a significantly lower drop-out rate than the sham/control groups did. Conclusions: The current study provided a new direction for the design of more methodologically robust and larger RCTs based on the findings of the potentially beneficial effect on migraine prophylaxis in participants with migraine by different noninvasive brain/nerve stimulation, especially the application of rTMS and tONS. Trial registration: CRD42021252638. The current study had been approval by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).

Original language	English
Article number	28
Journal	The journal of headache and pain
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s10194-022-01401-3
State	Published - 12 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Keywords

Migraine
Network meta-analysis
Non-invasive brain stimulation
Non-invasive nerve stimulation
Response rate

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10.1186/s10194-022-01401-3

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Cheng, Y. C., Zeng, B. Y., Hung, C. M., Su, K. P., Wu, Y. C., Tu, Y. K., Lin, P. Y., Stubbs, B., Carvalho, A. F., Liang, C. S., Chen, T. Y., Hsu, C. W., Brunoni, A. R., Suen, M. W., Shiue, Y. L., Tseng, P. T., Wu, M. K., & Li, C. T. (2022). Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials. The journal of headache and pain, 23(1), Article 28. https://doi.org/10.1186/s10194-022-01401-3

@article{76f5c7387d3543d6b9384f38013dbbe8,

title = "Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials",

abstract = "Background: Current pharmacologic prophylactic strategies for migraine have exhibited limited efficacy, with response rates as low as 40%–50%. In addition to the limited efficacy, the acceptability of those pharmacologic prophylactic strategies were unacceptable. Although noninvasive brain/nerve stimulation strategies may be effective, the evidence has been inconsistent. The aim of this network meta-analysis (NMA) was to compare strategies of noninvasive brain/nerve stimulation for migraine prophylaxis with respect to their effectiveness and acceptability. Methods: The PubMed, Embase, ScienceDirect, ProQuest, ClinicalTrials.gov, ClinicalKey, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov databases were systematically searched to date of June 4th, 2021 for randomized controlled trials (RCTs). Patients with diagnosis of migraine, either episodic migraine or chronic migraine, were included. All NMA procedures were conducted under the frequentist model. Results: Nineteen RCTs were included (N = 1493; mean age = 38.2 years; 82.0% women). We determined that the high frequency repetitive transcranial magnetic stimulation (rTMS) over C3 yielded the most decreased monthly migraine days among all the interventions [mean difference = − 8.70 days, 95% confidence intervals (95%CIs): − 14.45 to − 2.95 compared to sham/control groups]. Only alternating frequency (2/100 Hz) transcutaneous occipital nerve stimulation (tONS) over the Oz (RR = 0.36, 95%CIs: 0.16 to 0.82) yielded a significantly lower drop-out rate than the sham/control groups did. Conclusions: The current study provided a new direction for the design of more methodologically robust and larger RCTs based on the findings of the potentially beneficial effect on migraine prophylaxis in participants with migraine by different noninvasive brain/nerve stimulation, especially the application of rTMS and tONS. Trial registration: CRD42021252638. The current study had been approval by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).",

keywords = "Migraine, Network meta-analysis, Non-invasive brain stimulation, Non-invasive nerve stimulation, Response rate",

author = "Cheng, {Yu Chen} and Zeng, {Bing Yan} and Hung, {Chao Ming} and Su, {Kuan Pin} and Wu, {Yi Cheng} and Tu, {Yu Kang} and Lin, {Pao Yen} and Brendon Stubbs and Carvalho, {Andre F.} and Liang, {Chih Sung} and Chen, {Tien Yu} and Hsu, {Chih Wei} and Brunoni, {Andre R.} and Suen, {Mein Woei} and Shiue, {Yow Ling} and Tseng, {Ping Tao} and Wu, {Ming Kung} and Li, {Cheng Ta}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = dec,

doi = "10.1186/s10194-022-01401-3",

language = "英语",

volume = "23",

journal = "The journal of headache and pain",

issn = "1129-2377",

number = "1",

}

Cheng, YC, Zeng, BY, Hung, CM, Su, KP, Wu, YC, Tu, YK, Lin, PY, Stubbs, B, Carvalho, AF, Liang, CS, Chen, TY, Hsu, CW, Brunoni, AR, Suen, MW, Shiue, YL, Tseng, PT, Wu, MK & Li, CT 2022, 'Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials', The journal of headache and pain, vol. 23, no. 1, 28. https://doi.org/10.1186/s10194-022-01401-3

TY - JOUR

T1 - Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis

T2 - a network meta-analysis of randomized controlled trials

AU - Cheng, Yu Chen

AU - Zeng, Bing Yan

AU - Hung, Chao Ming

AU - Su, Kuan Pin

AU - Wu, Yi Cheng

AU - Tu, Yu Kang

AU - Lin, Pao Yen

AU - Stubbs, Brendon

AU - Carvalho, Andre F.

AU - Liang, Chih Sung

AU - Chen, Tien Yu

AU - Hsu, Chih Wei

AU - Brunoni, Andre R.

AU - Suen, Mein Woei

AU - Shiue, Yow Ling

AU - Tseng, Ping Tao

AU - Wu, Ming Kung

AU - Li, Cheng Ta

PY - 2022/12

Y1 - 2022/12

N2 - Background: Current pharmacologic prophylactic strategies for migraine have exhibited limited efficacy, with response rates as low as 40%–50%. In addition to the limited efficacy, the acceptability of those pharmacologic prophylactic strategies were unacceptable. Although noninvasive brain/nerve stimulation strategies may be effective, the evidence has been inconsistent. The aim of this network meta-analysis (NMA) was to compare strategies of noninvasive brain/nerve stimulation for migraine prophylaxis with respect to their effectiveness and acceptability. Methods: The PubMed, Embase, ScienceDirect, ProQuest, ClinicalTrials.gov, ClinicalKey, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov databases were systematically searched to date of June 4th, 2021 for randomized controlled trials (RCTs). Patients with diagnosis of migraine, either episodic migraine or chronic migraine, were included. All NMA procedures were conducted under the frequentist model. Results: Nineteen RCTs were included (N = 1493; mean age = 38.2 years; 82.0% women). We determined that the high frequency repetitive transcranial magnetic stimulation (rTMS) over C3 yielded the most decreased monthly migraine days among all the interventions [mean difference = − 8.70 days, 95% confidence intervals (95%CIs): − 14.45 to − 2.95 compared to sham/control groups]. Only alternating frequency (2/100 Hz) transcutaneous occipital nerve stimulation (tONS) over the Oz (RR = 0.36, 95%CIs: 0.16 to 0.82) yielded a significantly lower drop-out rate than the sham/control groups did. Conclusions: The current study provided a new direction for the design of more methodologically robust and larger RCTs based on the findings of the potentially beneficial effect on migraine prophylaxis in participants with migraine by different noninvasive brain/nerve stimulation, especially the application of rTMS and tONS. Trial registration: CRD42021252638. The current study had been approval by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).

AB - Background: Current pharmacologic prophylactic strategies for migraine have exhibited limited efficacy, with response rates as low as 40%–50%. In addition to the limited efficacy, the acceptability of those pharmacologic prophylactic strategies were unacceptable. Although noninvasive brain/nerve stimulation strategies may be effective, the evidence has been inconsistent. The aim of this network meta-analysis (NMA) was to compare strategies of noninvasive brain/nerve stimulation for migraine prophylaxis with respect to their effectiveness and acceptability. Methods: The PubMed, Embase, ScienceDirect, ProQuest, ClinicalTrials.gov, ClinicalKey, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov databases were systematically searched to date of June 4th, 2021 for randomized controlled trials (RCTs). Patients with diagnosis of migraine, either episodic migraine or chronic migraine, were included. All NMA procedures were conducted under the frequentist model. Results: Nineteen RCTs were included (N = 1493; mean age = 38.2 years; 82.0% women). We determined that the high frequency repetitive transcranial magnetic stimulation (rTMS) over C3 yielded the most decreased monthly migraine days among all the interventions [mean difference = − 8.70 days, 95% confidence intervals (95%CIs): − 14.45 to − 2.95 compared to sham/control groups]. Only alternating frequency (2/100 Hz) transcutaneous occipital nerve stimulation (tONS) over the Oz (RR = 0.36, 95%CIs: 0.16 to 0.82) yielded a significantly lower drop-out rate than the sham/control groups did. Conclusions: The current study provided a new direction for the design of more methodologically robust and larger RCTs based on the findings of the potentially beneficial effect on migraine prophylaxis in participants with migraine by different noninvasive brain/nerve stimulation, especially the application of rTMS and tONS. Trial registration: CRD42021252638. The current study had been approval by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).

KW - Migraine

KW - Network meta-analysis

KW - Non-invasive brain stimulation

KW - Non-invasive nerve stimulation

KW - Response rate

UR - http://www.scopus.com/inward/record.url?scp=85125020241&partnerID=8YFLogxK

U2 - 10.1186/s10194-022-01401-3

DO - 10.1186/s10194-022-01401-3

M3 - 文章

C2 - 35184742

AN - SCOPUS:85125020241

SN - 1129-2377

VL - 23

JO - The journal of headache and pain

JF - The journal of headache and pain

IS - 1

M1 - 28

ER -

Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials

Abstract

Bibliographical note

Keywords

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