ArticleThe journal of headache and pain2018
Anodal frontal tDCS for chronic cluster headache treatment: a proof-of-concept trial targeting the anterior cingulate cortex and searching for nociceptive correlates.
Article in The journal of headache and pain, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 24 citations in OpenAlex.
- Hallmarks of primary headache: part 3 - cluster headache.The journal of headache and pain · 2025Review
- [Using electricity to combat headache : Electrotherapy and tDCS in the 1870s/1880s and today].Schmerz (Berlin, Germany) · 2025Review
- Pain Lateralization in Cluster Headache and Associated Clinical Factors.Journal of clinical neurology (Seoul, Korea) · 2025Article
- Low-Intensity Focused Ultrasound to the Human Dorsal Anterior Cingulate Attenuates Acute Pain Perception and Autonomic Responses.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2024Article
- The Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) versus Transcranial Direct-Current Stimulation (tDCS) on Migraine Headaches: A Randomized Clinical Trial.Advanced biomedical research · 2024Article
- Aberrant functional connectivity in anterior cingulate gyrus subregions in migraine without aura patients.Frontiers in neurology · 2024Article
- Neuromodulation for Chronic Daily Headache.Current pain and headache reports · 2022Review
- Neurostimulation Treatment in Chronic Cluster Headache-a Narrative Review.Current pain and headache reports · 2021Review
- Role of the Anterior Cingulate Cortex in Translational Pain Research.Neuroscience bulletin · 2021Review
- Sex-Specific Abnormalities and Treatment-Related Plasticity of Subgenual Anterior Cingulate Cortex Functional Connectivity in Chronic Pain.Frontiers in pain research (Lausanne, Switzerland) · 2021Article
- Percutaneous Bioelectric Current Stimulation for Chronic Cluster Headache - A Possible Transformative Approach to Cluster Headache.Journal of pain research · 2020Article
- [Neuromodulation in primary headache in the year 2019: is it still up-to-date? : New data on invasive and non-invasive neuromodulation in migraine and cluster headaches].Schmerz (Berlin, Germany) · 2019Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundPercutaneous occipital nerve stimulation (ONS) is effective in refractory chronic cluster headache (rCCH) patients. Responders to ONS differ from non-responders by greater glucose metabolism in subgenual anterior cingulate cortex (sgACC). We reasoned that transcranial direct current stimulation (tDCS), a non-invasive approach, might be able to activate this area and thus improve rCCH patients. Our objective was to explore in a pilot trial the therapeutic potential of tDCS (anode at Fz, cathode over C7) and its possible effects on pain perception, frontal executive functions and mood in rCCH patients.
methodsThirty-one patients were asked to apply daily 20-min sessions of 2 mA tDCS for 4 or 8 weeks after a 1-month baseline. CH attacks were monitored with paper diaries. The primary outcome measure was change in weekly attacks between baseline and the last week of tDCS. Twenty-three patients were available for a modified ITT analysis, 21 for per-protocol analysis. We also explored treatment-related changes in thermal pain thresholds and nociceptive blink reflexes (nBR), frontal lobe function and mood scales.
resultsIn the per-protocol analysis there was a mean 35% decrease of attack frequency (p = 0.0001) with 41% of patients having a ≥ 50% decrease. Attack duration and intensity were also significantly reduced. After 8 weeks (n = 10), the 50% responder rate was 45%, but at follow-up 2 weeks after tDCS (n = 16) mean attack frequency had returned to baseline levels. The treatment effect was significant in patients with high baseline thermal pain thresholds in the forehead (n = 12), but not in those with low thresholds (n = 9). The Frontal Assessment Battery score increased after tDCS (p = 0.01), while there was no change in depression scores or nBR.
conclusiontDCS with a Fz-C7 montage may have a preventive effect in rCCH patients, especially those with low pain sensitivity, suggesting that a sham-controlled trial in cluster headache is worthwhile. Whether the therapeutic effect is due to activation of the sgACC that can in theory be reached by the electrical field, or of other prefrontal cortical areas remains to be determined.
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