Feasibility and clinical efficacy of repetitive neuromuscular magnetic stimulation in pediatric headache

Staisch, Jacob (2024): Feasibility and clinical efficacy of repetitive neuromuscular magnetic stimulation in pediatric headache. Dissertation, LMU München: Medizinische Fakultät

Abstract

Introduction: Pediatric primary headache disorders, including migraine, tension-type headache (TTH) and their mixed-type pose a significant burden on young individuals. Post-traumatic headache (PTH) is also to be emphasized as a secondary headache disorder due to its prevalence. Depending on frequency and severity of individual attacks, these headache disorders can represent a considerable burden. After we found repetitive neuromuscular magnetic stimulation (rNMS) to be safe, feasible and well accepted in young adults, in this analysis safety, feasibility, acceptance as well as clinical impact in the pediatric age group („first-in-child“) are retrospectively assessed. Materials and Methods: A cohort of n=33 children and adolescents who received n=182 rNMS sessions in a clinical setting are retrospectively analyzed regarding feasibility and effectiveness of rNMS targeting the upper trapezius muscle (UTM). Various parameters, including intensity and frequency of treatment, safety, central and muscular effects, and factors affecting the level of response are evaluated. Results: The project findings suggest that rNMS holds promise as a point-of-care nonpharmacological neuromodulation approach for pediatric headache disorders. It demonstrates that rNMS is practically feasible, safe, well-accepted (No adverse events in 76.8% of sessions, 94.7% of patients would undergo the treatment again, 85.3% would recommend the treatment). Therapeutically groundbreaking, the treatment seems to be associated with a significant reduction in headache frequency and intensity. Especially in PTH patients muscular hypersensitivity was reduced, and the reduction sustained until the follow-up assessment 3 months later. Neck pain then also emerged as a factor positively influencing the response to rNMS. Conclusion: Repetitive neuromuscular magnetic stimulation (rNMS) offers a new, nonpharmacological and personalized treatment option for children and adolescents with headache disorders as it was found to be safe, feasible, and highly accepted. In principle, rNMS appears to have a positive impact on headache symptoms - irrespective of the specific ICHD-3 diagnosis. Patients with neck pain seem biologically plausible to be particularly responsive which can be conceptually related to neuromodulation of central nociceptive processing within the trigemino-cervical complex. Despite clear limitations, this analysis provides a foundation for future research and the potential integration of rNMS into a multimodal regimen for pediatric headache disorders. Larger controlled studies are warranted to confirm and potentially develop the efficacy and utility of rNMS in this population further.

• 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: 6. November 2024
• 1. Bericht­erstatter:in: Heinen, Florian