The primary objective of this project is to investigate alternative non-pharmacological interventions for the management of migraines, specifically focusing on non-invasive brain stimulation (NIBS), in light of the limited efficacy and considerable side effects associated with current pharmacological treatments. A secondary objective is to evaluate the long-term effectiveness of NIBS, thereby addressing existing gaps in the literature. This meta-analysis seeks to systematically assess the analgesic effects of NIBS over both short and long durations, positing that NIBS will demonstrate superior efficacy compared to sham stimulation, with a minimal incidence of adverse effects.
This review, registered on PROSPERO (CRD42024529488) and following PRISMA guidelines, included RCTs on migraine patients treated with NIBS. A comprehensive search was conducted in PubMed/MEDLINE, Scopus, The Cochrane Library, EMBASE, Web of Science, CNKI, and VIP up to April 11, 2024. Outcomes consisted of headache frequency, pain intensity, duration, analgesic intake, and adverse effects. Methodological quality and risk of bias were independently evaluated by two researchers. Statistical analyses were performed by using Review Manager 5.3.
Thirteen studies involving 596 participants utilized rTMS or tDCS for migraine treatment in our analysis. The pooled results found that NIBS has both immediate and long-term effects in improving migraine-related symptoms. Notably, NIBS showed a bimodal response in long-term follow-up, meaning that NIBS is unable to lessen migraine frequency or severity in the period of three- to six-month follow-ups. Adverse events were similar between groups.
NIBS is an effective, preventive, and safe treatment for migraine but its long-term efficacy has been fluctuating.
This project elucidates the significant potential of non-invasive brain stimulation (NIBS) as an effective therapeutic intervention for migraines, emphasizing its immediate benefits and favorable safety profile. The findings are expected to inform physiotherapy practice by integrating NIBS into comprehensive, multidisciplinary migraine management strategies, thereby promoting its application as a preventive treatment. Additionally, the research outcomes will assist clinicians in customizing treatment protocols tailored to individual patient needs, while advocating for the incorporation of NIBS into clinical guidelines and policies concerning migraine management. Ultimately, this study aims to enhance the education and awareness of healthcare providers regarding NIBS, thereby fostering evidence-based practices that can improve patient outcomes in migraine care.
NIBS
efficacy
