Neuromodulation in Pediatric Migraine using Repetitive Neuromuscular Magnetic Stimulation: A Feasibility Study
Corinna Börner-Schröder,
Magdalena Lang,
Giada Urban,
Erik Zaidenstadt,
Jacob Staisch,
Ari Hauser,
Iris Hannibal,
Kristina Huß,
Birgit Klose,
Matthias F. Lechner,
Nico Sollmann,
Mirjam N. Landgraf,
Florian Heinen,
Michaela V. Bonfert
Affiliations
Corinna Börner-Schröder
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Magdalena Lang
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Giada Urban
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Erik Zaidenstadt
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Jacob Staisch
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Ari Hauser
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Iris Hannibal
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Kristina Huß
LMU Center for Children with Medical Complexity-iSPZ Hauner, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Birgit Klose
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Matthias F. Lechner
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Nico Sollmann
Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
Mirjam N. Landgraf
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Florian Heinen
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Michaela V. Bonfert
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, 80337 Munich, Germany
Migraine has a relevant impact on pediatric health. Non-pharmacological modalities for its management are urgently needed. This study assessed the safety, feasibility, acceptance, and efficacy of repetitive neuromuscular magnetic stimulation (rNMS) in pediatric migraine. A total of 13 patients with migraine, ≥6 headache days during baseline, and ≥1 myofascial trigger point in the upper trapezius muscles (UTM) received six rNMS sessions within 3 weeks. Headache frequency, intensity, and medication intake were monitored using headache calendars; headache-related impairment and quality of life were measured using PedMIDAS and KINDL questionnaires. Muscular involvement was assessed using pressure pain thresholds (PPT). Adherence yielded 100%. In 82% of all rNMS sessions, no side effects occurred. All participants would recommend rNMS and would repeat it. Headache frequency, medication intake, and PedMIDAS scores decreased from baseline to follow-up (FU), trending towards statistical significance (p = 0.089; p = 0.081, p = 0.055). A total of 7 patients were classified as responders, with a ≥25% relative reduction in headache frequency. PPT above the UTM significantly increased from pre- to post-assessment, which sustained until FU (p = 0.015 and 0.026, respectively). rNMS was safe, feasible, well-accepted, and beneficial on the muscular level. The potential to reduce headache-related symptoms together with PPT changes of the targeted UTM may underscore the interplay of peripheral and central mechanisms conceptualized within the trigemino-cervical complex.