EFFECT OF ANODAL TRANSCRANIAL DIRECT CURRENT STIMULATION (tDCS) OF PRIMARY MOTOR CORTEX ON HEADACHE FREQUENCY IN PATIENTS WITH CHRONIC MIGRAINE

July 29, 2026 updated by: Dr Ashish Kumar Duggal, Dr. Ram Manohar Lohia Hospital

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

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

32

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

      • New Delhi, India, 110001
        • Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Patients aged 18-60 years diagnosed with chronic migraine as per ICHD-3.
  2. 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.
  3. Willingness to provide informed consent and maintain a headache diary.

Exclusion Criteria:

  1. Patients with neurologic diseases such as tumours, seizures, dementia, meningitis, stroke, etc.
  2. Patients with barbiturate/opioid overuse or complications due to NSAID overuse.
  3. Patients failing to complete headache diary for more than 6 non-consecutive days during baseline.
  4. Illiterate patients without a caregiver to maintain the diary.
  5. Patients with pacemakers, cochlear implants.
  6. Pregnant women.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / 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

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

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

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Ashish K Duggal, DM Neurology, ABVIMS and Dr RML Hospital, New Delhi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 1, 2026

Primary Completion (Estimated)

January 31, 2027

Study Completion (Estimated)

January 31, 2027

Study Registration Dates

First Submitted

July 29, 2026

First Submitted That Met QC Criteria

July 29, 2026

First Posted (Actual)

August 4, 2026

Study Record Updates

Last Update Posted (Actual)

August 4, 2026

Last Update Submitted That Met QC Criteria

July 29, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • IEC/ABVIMS/RMLH/394

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

IPD collected throughout the trial will be available from the Principle Investigator upon reasonable request.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.