Repetitive neuromuscular magnetic stimulation as a novel treatment option in pediatric headache disorders

Lang, Magdalena (2025): Repetitive neuromuscular magnetic stimulation as a novel treatment option in pediatric headache disorders. Dissertation, LMU München: Medizinische Fakultät

Abstract

Neuromodulation using rNMS is a promising therapeutic approach for headache disorders (3-5, 14, 56). Besides tension-type headache and post-traumatic headache, migraine in particular is a common headache syndrome that is associated with a high prevalence in pediatric patients. Non-pharmacological, non-invasive prophylactic treatments are urgently needed, especially for children and adolescents (8, 10, 14). rNMS has already been applied in preliminary studies in adult migraine patients with mTrP in the shoulder-neck area and promising results have been achieved with regard to headache symptoms and the muscular component (1, 3). In order to pave the way for the implementation of this non-invasive therapeutic modality in the pediatric population, a prospective study and a retrospective data analysis regarding the use of rNMS in children and adolescents with primary headache disorders were conducted (4, 5). This dissertation included publications regarding the use of rNMS targeting the shoulder and neck muscles in children and adolescents with episodic migraine and mTrP in the trapezius muscle, as well as in pediatric patients with migraine, tension-type headache and post-traumatic headache. The feasibility, tolerability, acceptance, and clinical effects of rNMS in relation to headache symptoms and at the muscular level were investigated (4, 5, 73). For the prospective study, 14 patients were treated in six rNMS sessions, resulting in a total number of 84 rNMS sessions. To evaluate the adherence rate and feasibility of rNMS, standardized questionnaires were used to record the satisfaction and tolerability of the patients and their caregivers as well as the side effects during the intervention. Headache frequency, intensity and medication intake were recorded using a headache calendar from the German Society for Migraine and Headache Disorders. Muscular effects were evaluated by means of physiotherapeutic examination and algometry on the trapezius muscle. Questionnaires were completed to assess migraine-associated disability and quality of life. The acceptance, feasibility, and safety of rNMS was demonstrated. In addition, promising results were shown with regard to reduced headache frequency, medication use, reduced muscular hypersensitivity, and impairment in everyday life due to the headache disorder (4). The retrospective analysis achieved similar results with regard to the acceptance, safety, and tolerability of the therapeutic approach. Promising results were also achieved in the present analysis with regard to the central and muscular effects (5, 73). In summary, rNMS as a neuromodulatory treatment method for pediatric migraine and other headache disorders appears to be a practicable, well-tolerated, and well-accepted approach. The clinical effects of rNMS as a pediatric treatment method needs to be further evaluated in future, sham-controlled and larger-scale studies.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 23. Januar 2025
• 1. Bericht­erstatter:in: Heinen, Florian