Repetitive Neuromuscular Magnetic Stimulation for Pediatric Headache Disorders: Muscular Effects and Factors Affecting Level of Response

Corinna Börner; Jacob Staisch; Magdalena Lang; Ari Hauser; Iris Hannibal; Kristina Huß; Birgit Klose; Matthias F Lechner; Nico Sollmann; Florian Heinen; Mirjam N Landgraf; Michaela V Bonfert

doi:10.3390/brainsci12070932

Repetitive Neuromuscular Magnetic Stimulation for Pediatric Headache Disorders: Muscular Effects and Factors Affecting Level of Response

Brain Sci. 2022 Jul 16;12(7):932. doi: 10.3390/brainsci12070932.

Authors

Corinna Börner^{1

2

3

4}, Jacob Staisch^{1

2}, Magdalena Lang^{1

2}, Ari Hauser^{1

2}, Iris Hannibal^{1

2}, Kristina Huß^{1

2}, Birgit Klose^{1

2}, Matthias F Lechner^{1

2}, Nico Sollmann^{3

4

5}, Florian Heinen^{1

2}, Mirjam N Landgraf^{1

2}, Michaela V Bonfert^{1

2}

Affiliations

¹ LMU Hospital, Department of Pediatrics-Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany.
² LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany.
³ Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.
⁴ TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.
⁵ Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.

Abstract

Repetitive neuromuscular magnetic stimulation (rNMS) for pediatric headache disorders is feasible, safe, and alleviates headache symptoms. This study assesses muscular effects and factors affecting response to rNMS. A retrospective chart review included children with headaches receiving six rNMS sessions targeting the upper trapezius muscles. Pressure pain thresholds (PPT) were measured before and after rNMS, and at 3-month follow-up (FU). Mean headache frequency, duration, and intensity within the last 3 months were documented. In 20 patients (14.1 ± 2.7 years), PPT significantly increased from pre- to post-treatment (p < 0.001) sustaining until FU. PPT changes significantly differed between primary headache and post-traumatic headache (PTH) (p = 0.019−0.026). Change in headache frequency was significantly higher in patients with than without neck pain (p = 0.032). A total of 60% of patients with neck pain responded to rNMS (≥25%), while 20% of patients without neck pain responded (p = 0.048). 60% of patients receiving rNMS twice a week were responders, while 33% of patients receiving rNMS less or more frequently responded to treatment, respectively. Alleviation of muscular hyperalgesia was demonstrated sustaining for 3 months, which was emphasized in PTH. The rNMS sessions may positively modulate headache symptoms regardless of headache diagnosis. Patients with neck pain profit explicitly well. Two rNMS sessions per week led to the highest reduction in headache frequency.

Keywords: migraine; neuromodulation; neurostimulation; post-traumatic headache; tension-type headache.

Grants and funding

This research received no external funding. M.V.B.’s research concerning neuromodulation in migraine is supported by a scholarship from the Bavarian Gender Equality Grant of the Free State of Bavaria, Germany. M.V.B.’s research concerning pediatric mTBI is supported by the ZNS-Hannelore Kohl Stiftung, Germany. M.V.B.’s and N.S.’s research on rNMS in adult migraine are supported by a research grant from the Deutsche Migräne- und Kopfschmerzgesellschaft (DMKG).