Non-Invasive Neuromodulation for Episodic and Chronic Migraine Headache: Preliminary Findings on Feasibility of At-Home Transcranial Direct Current Stimulation With Remote Supervision
Bibliographic record
Abstract
Background: The outcomes of drug therapies in migraine vary and the development of novel non-pharmacological treatments is a priority. Non-invasive neuromodulation using transcranial direct current stimulation (tDCS) in small-sample studies with brief treatment protocols has shown preliminary efficacy in management of migraine symptoms. We have piloted a use of tDCS modified for applications of longer treatment protocols in home settings and conducted a pilot randomized sham-controlled study involving 60 daily at-home tDCS applications in migraine patients (targeted N = 60). The COVID-19 pandemic precipitated early study closure, and the final enrollment (N = 22) was insufficient to test efficacy. Here we report findings on treatment feasibility, adherence, and satisfaction. Methods: Participants were enrolled from the New York metropolitan area in 2018 - 2020. Main eligibility criteria included diagnosis of episodic or chronic migraine, history of headache for ≥ 1 year and ≥ 4 days with headache per month during a 30-day baseline period. At-home tDCS with remote supervision delivered the current at intensity of 1.5 mA or sham for one 20-min session per day on 60 consecutive days. The feasibility was determined by the drop-out rate after treatment started. Adherence was measured as the proportion of days during the 60-day study period that the patient activated the device. Satisfaction was evaluated from the satisfaction survey completed after the 60-day use of the device. Results: Thirty-six patients provided consent and were assessed for eligibility; 22 of them (17 F, 5 M, age of 38.4 ± 11.0 years) met eligibility criteria and were enrolled. Six patients dropped out after the intervention started; 16 patients (73% of enrolled) continued through the 60-day treatment. In this group, adherence was high; the mean (standard deviation (SD)) number of sessions per patient was 49.3 (13.1); the median was 52.5. All 16 patients were satisfied with education about tDCS and 13 (81%) found the use of the tDCS device easy. No significant adverse events occurred. Conclusions: At-home tDCS with remote supervision is feasible in migraine patients. If efficacy is confirmed in future research, at-home tDCS could become a useful tool for patients with severe migraine headache. J Neurol Res. 2024;14(1):37-42 doi: https://doi.org/10.14740/jnr760
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".