Effects of repetitive transcranial magnetic stimulation on electroencephalography, physical activity, sleep and psychological states of migraine patients

Migraine is one of the leading causes of morbidity in the world. This study is to explore repetitive transcranial magnetic stimulation (rTMS) as a preventive treatment of episodic migraine, analysing on its efficacy on headache days and other secondary health outcomes. This study is part of the main clinical trial; MAGNET-EM; a double￾blinded randomised, controlled trial which included seventy-six participants randomised into treatment arm and sham arm. Full protocol of the clinical trial was published and registered at clinicaltrial.gov. This study analyses the secondary health outcomes; on difference of electroencephalography (EEG), sleep, physical activities, sleep as well as mental health. The measures used for each outcome were observed EEG changes, GPAQ, PSQI, DASS-21 questionnaires were given to the participants pre- and post-RTMS respectively. The study found a statistically significant difference in the proportion of photic driving response pre- and post-rTMS, p = .0001, ηp² = .336) in the rTMS group vs. placebo. Sleep scores did not yield any significant changes but there was statistically significant improvement in physical activity (p=0.015.). In terms of mental health, there was reduction in the depression score (X² = 9.60, p = 0.022) and stress score, p=0.052 in the rTMS group vs placebo. However, there is no significant changes of anxiety scores and sleep scores. To conclude, the rTMS may have some beneficial effects on improving secondary health outcomes such as the photic drive responses, physical activity and depression in patient with episodic migraine. Although this is an early finding, the current rTMS study protocol could be used by clinician as an early adjunctive treatment for migraine patient with comorbid depression.

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