Evidence map›Paper›PMID 34698941›Full record

SynthesisNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2022

Non-invasive neuromodulation in the acute treatment of migraine: a systematic review and meta-analysis of randomized controlled trials.

Oliver Clark, Areej Mahjoub, Nily Osman, Ann-Marie Surmava, Saber Jan, Ana Marissa Lagman-Bartolome

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 4 pooled it
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 4 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Migraine Management in Medically Complex Patients: a Narrative Review.Current neurology and neuroscience reports · 2024
    Review
  7. Review
  8. Review
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  10. Review
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Oliver ClarkDepartment of Internal Medicine, Pennsylvania Hospital, 800 Spruce St, Philadelphia, PA, 19107, USA.ORCID http://orcid.org/0000-0003-4937-2158
Areej MahjoubDivision of Pediatric Neurology, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G1X8, Canada.
Nily OsmanWomen's College Hospital, University of Toronto, 76 Grenville St, Toronto, ON, M5S1B2, Canada.
Ann-Marie SurmavaUniversity of Toronto, 27 King's College Circle, Toronto, ON, M5S 3K1, Canada.
Saber JanDepartment of Pediatrics, Taibah University, Janadah Bin Umayyah Road, Tayba, Medina, Saudi Arabia.
Ana Marissa Lagman-BartolomeDivision of Pediatric Neurology, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G1X8, Canada. marissa.lagman@wchospital.ca.
University of Toronto · CAHospital for Sick Children · CAPennsylvania Hospital · USTaibah University · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveA systematic review and meta-analysis was performed to determine the efficacy of non-invasive neuromodulation modalities for the treatment of acute migraine.

backgroundAlthough pharmacological treatments are the gold standard for the management of acute migraine, some patients may require non-pharmacological treatment options. Non-invasive neuromodulation may provide an alternative, and techniques include transcranial magnetic stimulation (TMS), non-invasive vagal nerve stimulation (nVNS), non-painful remote electrical stimulation (NRES), and external trigeminal nerve stimulation (e-TNS).

methodsThis systematic review and meta-analysis was performed following PRISMA guidelines. We searched PUBMED, EMBASE, ClinicalTrials.gov, Cochrane Center Register of Controlled Trials, and LILACS databases. We included randomized controlled clinical trials studying patients with migraine treated with any form of non-invasive neuromodulation. Primary outcome was pain freedom within 2 h post-treatment. Secondary outcomes were pain relief within 2-h post-treatment and sustained pain freedom and sustained pain relief 48 h post-treatment.

resultsPooled analysis demonstrated a significant effect of non-invasive neuromodulation on pain-free rates within 2 h (RR, 1.66; 95% CI, 1.35 to 2.05; P < 0.00001) and pain relief rates within 2 h (RR, 1.52; 95% CI, 1.13 to 2.05; P = 0.005) post-treatment. Non-invasive neuromodulation had no significant effect on sustained pain freedom at 48 h (RR, 1.56; 95% CI, 0.68 to 3.59; P = 0.29) or sustained pain relief at 48 h (RR, 1.47; 95% CI, 0.57 to 3.77; P = 0.43) after administration.

conclusionNeuromodulation has demonstrated some efficacy in acute migraine management and may be considered in the treatment paradigm of acute migraine in patients with contraindications to pharmacological therapies.

Indexed as

Migraine DisordersVagus Nerve StimulationHumansPain ManagementRandomized Controlled Trials as TopicTreatment OutcomeExternal trigeminal nerve stimulation (e-TNS)MigraineNeuromodulationNon-invasive vagal nerve stimulation (nVNS)Non-painful remote electrical stimulation (NRES)Transcranial magnetic stimulation (TMS)

Identifiers

PMID34698941
OpenAlexW3209205502

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.