• Headache · Sep 2012

    Randomized Controlled Trial

    tDCS-induced analgesia and electrical fields in pain-related neural networks in chronic migraine.

    • Alexandre F Dasilva, Mariana E Mendonca, Soroush Zaghi, Mariana Lopes, Marcos Fabio Dossantos, Egilius L Spierings, Zahid Bajwa, Abhishek Datta, Marom Bikson, and Felipe Fregni.
    • Headache & Orofacial Pain Effort, Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
    • Headache. 2012 Sep 1;52(8):1283-95.

    ObjectiveWe investigated in a sham-controlled trial the analgesic effects of a 4-week treatment of transcranial direct current stimulation (tDCS) over the primary motor cortex in chronic migraine. In addition, using a high-resolution tDCS computational model, we analyzed the current flow (electric field) through brain regions associated with pain perception and modulation.MethodsThirteen patients with chronic migraine were randomized to receive 10 sessions of active or sham tDCS for 20 minutes with 2 mA over 4 weeks. Data were collected during baseline, treatment and follow-up. For the tDCS computational analysis, we adapted a high-resolution individualized model incorporating accurate segmentation of cortical and subcortical structures of interest.ResultsThere was a significant interaction term (time vs group) for the main outcome (pain intensity) and for the length of migraine episodes (ANOVA, P < .05 for both analyses). Post-hoc analysis showed a significant improvement in the follow-up period for the active tDCS group only. Our computational modeling studies predicted electric current flow in multiple cortical and subcortical regions associated with migraine pathophysiology. Significant electric fields were generated, not only in targeted cortical regions but also in the insula, cingulate cortex, thalamus, and brainstem regions.ConclusionsOur findings give preliminary evidence that patients with chronic migraine have a positive, but delayed, response to anodal tDCS of the primary motor cortex. These effects may be related to electrical currents induced in pain-related cortical and subcortical regions.© 2012 American Headache Society.

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