Grazzi et al.1717 Grazzi L, Usai S, Bolognini N, Grignani E, Sansone E, Tramacere I, Maravita A, Lauria G. No efficacy of transcranial direct current stimulation on chronic migraine with medication overuse: A double blind, randomised clinical trial. Cephalalgia. 2020;40(11):1202-11.
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135 patients of both biological genders |
Stimulation was applied daily, for a period of 20 minutes and current intensity of 2mA, for 5 consecutive days during the medication withdrawal program. Patients were randomized to receive anodal, cathodal, or sham tDCS. In all cases, the active electrode was placed over the right-sided primary motor cortex (site C4 of the 10/20 EEG system) with the reference electrode placed over the contralateral supraorbital area. |
TDCS did not influence the shortand long-term course of chronic migraine with medication overuse after acute drug withdrawal. Catastrophizing was reduced in both target groups. |
1B/strong recom- mendation, moderate quality evidence |
Rahimi et al.2222 Rahimi MD, Fadardi JS, Saeidi M, Bigdeli I, Kashiri R. Effectiveness of cathodal tDCS of the primary motor or sensory cortex in migraine: a randomized controlled trial. Brain Stimul. 2020;13(3):675-82.
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45 patients of both biological genders |
The active electrode (cathode) was placed at C4 in the experimental and sham groups. In the sham, the device provided the electrical current only in the first and last 30 seconds of the experiment. |
The application of cathodal tDCS in M1 or S1 can be used as a technological intervention for the prophylactic and therapeutic treatment of episodic or chronic migraine. |
1A/strong recommendation, highquality evidence. |
Cerrahoğlu Şirin et al.1818 Cerrahoğlu Şirin T, Aksu S, Hasirci Bayir BR, Ulukan Ç, Karamürsel S, Kurt A, Baykan B. Is allodynia a determinant factor in the effectiveness of transcranial direct current stimulation in the prophylaxis of migraine? Neuromodulation. 2021;24(5):899-909.
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77 patients of both biological genders |
41 patients received sham stimulation and 36 patients underwent three sessions of anodal tDCS stimulation in the left primary motor cortex with a current of 2 mA for 20 minutes. |
TDCS is a safe, effective and rapid method for migraine prophylaxis. However, administration of tDCS before allodynia occurs, that is, before the development of central sensitization, will provide greater responsiveness to treatment. |
1A/strong recommendation, high- -quality evidence. |
Hodaj et al.2424 Hodaj H, Payen JF, Mick G, Vercueil L, Hodaj E, Dumolard A, Noëlle B, Delon-Martin C, Lefaucheur JP. Long-term prophylactic efficacy of transcranial direct current stimulation in chronic migraine. A randomised, patient-assessor blinded, sham-controlled trial. Brain Stimul. 2022;15(2):441-53.
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36 patients of both biological genders |
The tDCS protocol consisted of 5 consecutive daily sessions during the first week (week 1) followed by a maintenance phase of 1 weekly session during the following 4 weeks and 2 bimonthly sessions in the following month, for a total of 11 sessions. The anode was placed in C3 to reach the hand area in the left motor cortex and the cathode was placed in FP2, that is, the right supra orbital area. A constant current of 2 mA intensity was applied for 20 min. For the sham, the electrodes were placed in a similar manner, but the current was stopped 30 seconds later. |
The monthly number of migraine episodes was reduced after tDCS in the active group compared to the sham group. The response rate was higher 3 months after the tDCS protocol in the active group compared to the sham group. |
1A/strong recommendation, highquality evidence. |
Dawood Rahimi et al.2626 Dawood Rahimi M, Taghi Kheirkhah M, Salehi Fadardi J. Efficacy of tDCS in chronic migraine: A multiprotocol randomized controlled trial. Clin Neurophysiol. 2023;150:119-30.
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150 patients of both biological genders |
Target areas: right ventrolateral prefrontal cortex, left dorsomedial and superior frontal gyrus and the right/left primary motor area, the medial crosstalk of the hemispheres, and the occipital cortex. |
There were significant reductions (p < 0.05) in chronic migraine symptoms in the intervention groups compared with sham. tDCS can be used as an effective intervention for the prophylactic and therapeutic treatment of chronic migraine. |
1A/strong recommendation, highquality evidence. |