经颅交流电刺激治疗无先兆偏头痛的临床研究

Transcranial alternating current stimulation in migraine without aura

目的探讨经颅交流电刺激(tACS)治疗无先兆偏头痛的疗效及安全性。方法采用前瞻性研究设计, 连续纳入自2021年6月至2022年6月于郑州大学第二附属医院神经内科眩晕中心就诊的40例无先兆偏头痛患者, 按简单随机法分配到真组(20例)与伪组(20例), 进行连续8周的治疗及随访观察(前4周为治疗期, 后4周为随访期), 其中伪组患者不予电流刺激, 真组患者通过安放在前额部和双侧乳突部的电极片发出77.5 Hz、15 mA的交流电接收刺激(2次/d, 每次40 min, 5 d为1个疗程, 共4个疗程)。分别于治疗前、治疗期末和随访期末时评估患者的疗效观察指标及不良反应发生情况。结果与治疗前相比, 真组患者治疗期末及随访期末时平均每月偏头痛发作天数、视觉模拟量表(VAS)评分、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分均明显下降, 偏头痛特异性生活质量问卷(MSQ)评分明显升高, 差异均有统计学意义(P<0.05)。与伪组相比, 真组患者治疗期末及随访期末时平均每月偏头痛发作天数、VAS评分、PSQI、HAMA评分和HAMD评分均明显下降, MSQ评分明显升高, 差异均有统计学意义(P<0.05)。2组患者治疗及随访期间均未发生癫痫发作、听力下降、头皮灼伤、头晕、耳鸣等不良反应。结论 tACS能明显降低无先兆偏头痛患者偏头痛发生频率及疼痛程度, 提高患者生活质量, 且安全性好。

Objective To investigate the efficacy and safety of transcranial alternating current stimulation(tACS)in treating migraine without aura.Methods A prospective study was performed.From June 2021 to June 2022,40 migraine without aura patients treated at Vertigo Center,Department of Neurology,Second Affiliated Hospital of Zhengzhou University were enrolled;they were randomly assigned to true group(n=20)and pseudo group(n=20);treatment was given for 4 consecutive weeks and follow-up was given for 4 weeks.Pseudo group did not receive current stimulation,while true group received stimulation by 77.5 Hz,15 mA alternating current through electrodes placed on the forehead and bilateral mastoid(twice/d,40 min each time,5 d as a course,a total of 4 courses).Efficacies and adverse reactions were assessed before treatment,and at the end of treatment and followup,respectively.Results Compared with pseudo group,the average monthly migraine days,visual analog scale(VAS)scores,Pittsburgh Sleep Quality Index(PSQI),Hamilton Anxiety Scale(HAMA)scores and Hamilton Depression Scale(HAMD)scores decreased statistically in true group(P<0.05),and Migraine-specific Quality of Life Questionnaire(MSQ)scores increased statistically in true group(P<0.05).In true group,compared with those before treatment,the average monthly migraine days,VAS scores,PSQI,HAMA scores and HAMD scores significantly decreased,and MSQ scores increased statistically at the end of treatment and follow-up(P<0.05).During treatment,no adverse reactions such as seizures,hearing loss,scalp burns,dizziness,or tinnitus were noted in true group and pseudo group.Conclusion Repeated tACS can obviously reduce frequency and degree of migraine,improve quality of life in migraine without aura patients;and good safety can be recorded.