Zap that migraine before it even starts!

Jun 22 2006

Millions of people who suffer from migraine could be helped by an experimental device which zaps the pain before an attack gets going.

The electronic device called TMS (Transcranial Magnetic Stimulation) interrupts the aura phase of the migraine, often described as electrical storms in the brain, before they lead to headaches.

Auras are neural disturbances that signal the onset of migraine headaches.

Migraine sufferers often describe "seeing" showers of shooting stars, zigzagging lines, flashing lights and experiencing loss of vision, weakness, tingling or confusion. This is usually followed by an throbbing headache, nausea and vomiting.

The knowledge that it was the neuronal electrical hyper excitability which instigated the headache, prompted the development of the TMS device.

In a 3-month study by neurology researchers at the Ohio State University Medical Center, it was found that the experimental device appeared to be effective in eliminating the headache when used at the start of the migraine.

Dr. Yousef Mohammad, a neurologist at OSU Medical Center who presented the results at the annual American Headache Society meeting in Los Angeles, says the patients in the study reported a significant reduction in nausea, noise and light sensitivity after treatment.

Dr. Mohammad, the principal investigator of the study, says possibly the most significant effect of using the TMS device was on the two-hour symptom assessment, with 84 percent of the episodes in patients using the TMS occurring without noise sensitivity.

Work functioning also improved, and there were no side effects reported.

It appears the stimulator sends a strong electric current through a metal coil, which creates an intense magnetic field for about one millisecond.

This magnetic pulse, when held against a person’s head, creates an electric current in the neurons of the brain, interrupting the aura before it results in a throbbing headache.

Dr. Mohammad says the device's pulses are painless and patients simply feel a little pressure.

In the study which included eight migraine-with-aura patients, the participants were able to use any preventive medication they might be taking but were banned from taking painkillers or triptan drugs for treating the migraine once it had started.

The group were taught to use a portable device, which they held to the back of their head which delivered two TMS pulses 30 seconds apart as soon as they experienced an aura.

During the study a total of 31 migraines were experienced and for 81 percent of these episodes the patients reported that they were headache-free within 2 hours of using the device.

The patients rated their response to the treatment as very good or excellent for 55 percent of the attacks and in almost three-quarters of the headaches, TMS eliminated nausea and sensitivity to noise and light.

A controlled trial with 42 migraine patients who were randomly to TMS treatment or inactive placebo treatment found the TMS group had either no pain or only mild pain 2 hours after treatment in 69 percent of headache episodes, whereas the placebo group experienced similar relief for 48 percent of episodes.

After the TMS treatment, work functioning was improved for 86 percent of headache episodes, versus 56 percent of the episodes in the placebo group.

Mohammad and his associates have begun a large, randomized clinical trial that will include patients with migraine with or without aura to validate these early findings.

NeuraLieve, a company in California provided the funding and equipment for the study.