Tracking tDCS induced grey matter changes in episodic migraine: a randomized controlled trial

Simon Schading; Heiko Pohl; Andreas Gantenbein; Roger Luechinger; Peter Sandor; Franz Riederer; Patrick Freund; Lars Michels

doi:10.1186/s10194-021-01347-y

Tracking tDCS induced grey matter changes in episodic migraine: a randomized controlled trial

J Headache Pain. 2021 Nov 20;22(1):139. doi: 10.1186/s10194-021-01347-y.

Authors

Simon Schading¹, Heiko Pohl², Andreas Gantenbein^{2

3}, Roger Luechinger⁴, Peter Sandor^{2

3}, Franz Riederer^{2

5}, Patrick Freund^#^{1

6

7}, Lars Michels^#⁸

Affiliations

¹ Spinal Cord Injury Centre Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
² Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
³ ZURZACH Care, Bad Zurzach, Switzerland.
⁴ Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland.
⁵ Neurological Center Rosenhügel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria.
⁶ Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, UK.
⁷ Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
⁸ Department of Neuroradiology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland. lars.michels@usz.ch.

^# Contributed equally.

Abstract

Background: Occipital transcranial direct current stimulation (tDCS) is an effective and safe treatment for migraine attack prevention. Structural brain alterations have been found in migraineurs in regions related to pain modulation and perception, including occipital areas. However, whether these structural alterations can be dynamically modulated through tDCS treatment is understudied.

Objective: To track longitudinally grey matter volume changes in occipital areas in episodic migraineurs during and up to five months after occipital tDCS treatment in a single-blind, and sham-controlled study.

Methods: 24 episodic migraineurs were randomized to either receive verum or sham occipital tDCS treatment for 28 days. To investigate dynamic grey matter volume changes patients underwent structural MRI at baseline (prior to treatment), 1.5 months and 5.5 months (after completion of treatment). 31 healthy controls were scanned with the same MRI protocol. Morphometry measures assessed rate of changes over time and between groups by means of tensor-based morphometry.

Results: Before treatment, migraineurs reported 5.6 monthly migraine days on average. A cross-sectional analysis revealed grey matter volume increases in the left lingual gyrus in migraineurs compared to controls. Four weeks of tDCS application led to a reduction of 1.9 migraine days/month and was paralleled by grey matter volume decreases in the left lingual gyrus in the treatment group; its extent overlapping with that seen at baseline.

Conclusion: This study shows that migraineurs have increased grey matter volume in the lingual gyrus, which can be modified by tDCS. Tracking structural plasticity in migraineurs provides a potential neuroimaging biomarker for treatment monitoring.

Trial registration: ClinicalTrials.gov , NCT03237754 . Registered 03 August 2017 - retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03237754 .

Keywords: Brain plasticity; Migraine; Structural MRI; Structural alterations; Transcranial direct current stimulation; Voxel-based morphometry.

Publication types

Randomized Controlled Trial

MeSH terms

Cross-Sectional Studies
Gray Matter / diagnostic imaging
Humans
Migraine Disorders* / diagnostic imaging
Migraine Disorders* / therapy
Single-Blind Method
Transcranial Direct Current Stimulation*

Associated data

ClinicalTrials.gov/NCT03237754