EFFECT OF ANODAL TRANSCRANIAL DIRECT CURRENT STIMULATION (tDCS) OF PRIMARY MOTOR CORTEX ON HEADACHE FREQUENCY IN PATIENTS WITH CHRONIC MIGRAINE
Migraine is a common, heterogeneous neurological disorder affecting approximately 10-15% of the global population and is the third most prevalent disease worldwide. A wide range of pharmacological agents is available for migraine prophylaxis, with treatment selection generally guided by the patient's clinical profile, associated comorbidities, and individual tolerability. However, the effectiveness of preventive medications is often limited by adverse effects, leading to poor treatment adherence and discontinuation. Consequently, non-pharmacological interventions, particularly neuromodulation techniques, have gained increasing attention as potential therapeutic options for chronic migraine.
Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has demonstrated efficacy in modulating refractory pain in patients with chronic migraine, fibromyalgia, spinal cord injury, and trigeminal neuralgia. In addition, it has shown therapeutic benefits in several neurological and psychiatric disorders, including depression, stroke, epilepsy, and Parkinson's disease. The present study aims to evaluate the efficacy of anodal tDCS applied over the primary motor cortex as an adjunctive therapy for reducing headache frequency in patients with chronic migraine.
A total of 32 participants with chronic migraine will be enrolled and randomized using block randomization with a block size of four, stratified according to the presence or absence of medication-overuse headache (MOH), through an online randomization generator. Participants will be allocated to receive either active or sham tDCS. Before randomization, all eligible patients will maintain a baseline headache diary for four weeks while continuing their existing prophylactic medications. Thereafter, they will undergo three 20-minute stimulation sessions administered during weeks 1, 5, and 9. Treatment outcomes will be evaluated at weeks 5, 9, and 12 using headache diary records and predefined objective assessment tools.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Ashish Duggal, DM (Neurology)
- Phone Number: +919810523332
- Email: ashishduggal2005@gmail.com
Study Contact Backup
- Name: Ketan Bhatnagar, Pursuing DM Neurology
- Phone Number: +917062874305
- Email: Ketanbhatnagar2024@gmail.com
Study Locations
-
-
-
New Delhi, India, 110001
- Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital
-
Contact:
- Ashish Duggal, DM (Neurology)
- Phone Number: +919810523332
- Email: ashishduggal2005@gmail.com
-
Contact:
- Ketan Bhatnagar, Pursuing DM Neurology
- Phone Number: +917062874305
- Email: Ketanbhatnagar2024@gmail.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients aged 18-60 years diagnosed with chronic migraine as per ICHD-3.
- Patients who were on a minimum of one concomitant preventive medication for not less than three months duration and a dose that was stable for at least one month prior to randomization.
- Willingness to provide informed consent and maintain a headache diary.
Exclusion Criteria:
- Patients with neurologic diseases such as tumours, seizures, dementia, meningitis, stroke, etc.
- Patients with barbiturate/opioid overuse or complications due to NSAID overuse.
- Patients failing to complete headache diary for more than 6 non-consecutive days during baseline.
- Illiterate patients without a caregiver to maintain the diary.
- Patients with pacemakers, cochlear implants.
- Pregnant women.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Anodal TDCS Arm (will receive true tDCS)
Will receive true Anodal tDCS
|
Patients in group A will receive true anodal stimulation
Patients in group B will receive Sham stimulation
|
|
Sham Comparator: Sham tDCS Arm (will receive sham stimulation)
Will receive sham tDCS stimulation
|
Patients in group A will receive true anodal stimulation
Patients in group B will receive Sham stimulation
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in frequency of moderate-severe headache days (week 12 vs baseline).
Time Frame: 12 weeks
|
Change in the number of monthly moderate-to-severe headache days from baseline to Week 12, as recorded in the participant headache diary.
|
12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in migraine days (week 12 vs baseline).
Time Frame: 12 weeks
|
Change in the frequency of monthly migraine days from baseline to Week 12, as recorded in the participant headache diary.
|
12 weeks
|
|
50% responder rate
Time Frame: 12 weeks
|
The number of patients having a 50% reduction in migraine days per month in both groups was calculated at week 12
|
12 weeks
|
|
Change in headache severity (week 12 vs baseline).
Time Frame: 12 weeks
|
The change in headache severity will be assessed at week 12 from baseline in terms of visual analogue score (0-3)
|
12 weeks
|
|
Change in number of days with acute medication use (week 12 vs baseline)
Time Frame: 12 weeks
|
Change in the number of days requiring acute migraine medication use per month from baseline to Week 12, as recorded in the participant headache diary.
|
12 weeks
|
|
Change in PHQ-9 scores (week 12 vs baseline)
Time Frame: 12 weeks
|
Change in Patient Health Questionnaire-9 (PHQ-9) scores from baseline to Week 12
|
12 weeks
|
|
Change in MIDAS score (week 12 vs baseline)
Time Frame: 12 weeks
|
Change in Migraine Disability Assessment (MIDAS) scores from baseline to Week 12, assessing changes in migraine-related disability.
|
12 weeks
|
|
Change in HIT - 6 scores (week 12 vs baseline)
Time Frame: 12 weeks
|
Change in Headache Impact Test-6 (HIT-6) scores from baseline to Week 12, assessing the impact of headache on daily functioning and health-related quality of life.
|
12 weeks
|
|
Change in Migraine specific Quality of Life (week 12 vs baseline)
Time Frame: 12 weeks
|
Change in Migraine-Specific Quality of Life (MSQ) scores from baseline to Week 12, assessing changes in migraine-related quality of life.
|
12 weeks
|
|
Safety Outcome - Adverse events reported by the patients after each session of tDCS
Time Frame: 12 weeks
|
Incidence and severity of adverse events reported by participants following each transcranial direct current stimulation (tDCS) session, monitored throughout the study period.
|
12 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Ashish K Duggal, DM Neurology, ABVIMS and Dr RML Hospital, New Delhi
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Headache Disorders
- Headache
- Therapeutics
- Behavioral Disciplines and Activities
- Electric Stimulation Therapy
- Convulsive Therapy
- Psychiatric Somatic Therapies
- Electroshock
- Psychological Techniques
- Transcranial Direct Current Stimulation
Other Study ID Numbers
Other Study ID Numbers
- IEC/ABVIMS/RMLH/394
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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