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

作者：Yu‐Chen Cheng, Bing‐Yan Zeng, Chao‐Ming Hung, Kuan‐Pin Su, Yi‐Cheng Wu, Yu‐Kang Tu, Pao‐Yen Lin, Brendon Stubbs, André F. Carvalho, Chih‐Sung Liang, Tien‐Yu Chen, Chih‐Wei Hsu, André R. Brunoni, Mein‐Woei Suen, Yow‐Ling Shiue, Ping‐Tao Tseng, Ming‐Kung Wu, Cheng‐Ta Li · 发表于：The Journal of Headache and Pain · 年份：2022 · DOI：10.1186/s10194-022-01401-3 · 被引用次数：28 · 研究领域：Migraine and Headache Studies、Transcranial Magnetic Stimulation Studies、Traumatic Brain Injury Research

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 si...