Chronic Migraine Clinical Trial
Official title:
Cathodal Transcranial Direct Current Stimulation in Chronic Migraine: Neurophysiological Study and Pilot Therapeutic Trial
Cathodal tDCS decreases the excitability of the cerebral cortex and its daily application during intercritical phase, may have a therapeutic effect in chronic migraine.
During the interictal phase, the cerebral cortex is characterised by a hyperresponsiveness to
repeated sensory stimuli, manifested by a lack of habituation or adaptation of cortical
responses. Lack of habituation has been shown in the visual cortex in studies of visual
evoked potentials (VEP) during the interictal period and it is possibly explained by a
reduction in the cortical pre-activation level due to thalamo-cortical dysrhythmia. Just
before and during the migraine attack, cortical reactivity changes drastically: habituation
is restored and the amplitude increases. In chronic migraine (headache occurring on 15 or
more days per month for more than 3 months with features of migraine headache on at least 8
days per month), VEPs habituate normally like those recorded during attacks of episodic
migraine, but have in addition an increased amplitude in the 1st block of responses. Chronic
migraine was therefore compared to a "never ending migraine attack" accompanied by cortical
hypersensitivity.
In this study the investigators aim to demonstrate that cathodal tDCS over the visual cortex
with simultaneous anodal tDCS over the left dorsolateral prefrontal cortex is able: 1) to
reduce cortical hypersensitivity and habituation as assessed by VEPs and contact heat evoked
nociceptive potentials (CHEPS), as well as to decrease pain perception assessed by
quantitative sensory testing (QST) and the nociceptive blink reflex (nBR); 2) to decrease
headache and migraine frequency.
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