PLoS ONE (Jan 2021)

High-frequency repetitive transcranial magnetic stimulation at dorsolateral prefrontal cortex for migraine prevention: A protocol for a systematic review of controlled trials.

  • Nabil Izzaatie Mohamad Safiai,
  • Nur Afiqah Mohamad,
  • Hamidon Basri,
  • Liyana Najwa Inche Mat,
  • Fan Kee Hoo,
  • Anna Misyail Abdul Rashid,
  • Abdul Hanif Khan Yusof Khan,
  • Wei Chao Loh,
  • Janudin Baharin,
  • Aaron Fernandez,
  • Intan Nureslyna Samsudin,
  • Mohd Hazmi Mohamed,
  • Mooi Ching Siew,
  • Kai Wei Lee,
  • Vasudevan Ramachandran,
  • Patricia Pozo-Rosich,
  • Wan Aliaa Wan Sulaiman

DOI
https://doi.org/10.1371/journal.pone.0251528
Journal volume & issue
Vol. 16, no. 6
p. e0251528

Abstract

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BackgroundMigraine may lead to a negative impact on the patients' quality of life with a subsequent substantial burden to society. Therapy options for treatment and prevention of migraine have progressed over the years and repetitive transcranial magnetic stimulation (rTMS) is one of the promising non-pharmacological options. It induces and alters electric current in the brain via repetitive non-invasive brain stimulation in high frequency. In migraine patients, two common stimulation sites are the M1 cortex and dorsolateral prefrontal cortex (DLPFC). The mechanism on how rTMS exerts therapeutic effects on migraine is not fully established, but the main postulation is that the neuromodulation via high-frequency rTMS (hf-rTMS) might inhibit pain perception. However, evidence from studies has been conflicting, thus the usefulness of hf-rTMS as migraine preventive treatment is still uncertain at this moment.MethodsThis is a systematic review protocol describing essential reporting items based on the PRISMA for systematic review protocols (PRISMA-P) (Registration number: CRD42020220636). We aim to review the effectiveness, tolerability, and safety of hf-rTMS at DLPFC in randomised controlled trials (RCTs) as migraine prophylactic treatment. We will search Scopus, Cumulative Index to Nursing and Allied Health Literature Plus, PubMed, Cochrane Central Register of Controlled Trials and Biomed Central for relevant articles from randomised controlled clinical trials that used hf-rTMS applied at DLPFC for the treatment of migraine. The risk of bias will be assessed using the version 2 "Risk of bias" tool from Cochrane Handbook for Systematic Reviews of Interventions Version 6.1. We will investigate the evidence on efficacy, tolerability and safety and we will compare the outcomes between the hf-rTMS intervention and sham groups.DiscussionThis systematic review will further determine the efficacy, safety, and tolerability of hf-rTMS applied at DLPFC for migraine prophylaxis. It will provide additional data for health practitioners and policymakers about the usefulness of hf-rTMS for migraine preventive treatment.