Objective To systematically analyze the clinical efficacy and safety of repetitive transcranial magnetic stimulation in the prevention of chronic migraine.Methods A computer search was conducted on Chinese National Knowledge Infrastructure,Wanfang Med Online,VIP Chinese Science and Technology Journal Database,PubMed,EMBASE and Cochrane Library were systematically searched until January 2023.The randomized controlled trial(RCT)of transcranial magnetic stimulation versus sham magnetic stimulation for the prevention of chronic migraine were included.RevMan5.3 software was used for statistical analysis.Results A total of 4 RCT studies involving 83 patients with chronic migraine were included.The results of Meta-analysis showed that repetitive transcranial magnetic stimulation could reduce the frequency of headache attacks in patients with chronic migraine(n=83,MD=-7.72,95%CI:-14.00 to-1.45,Z=2.41,P=0.02),and reduce the frequency of acute analgesic use in patients with chronic migraine(n=69,MD=-8.93,95%CI:-17.55 to-0.32,Z=2.03,P=0.04).However,it could not significantly reduce the Migraine Disability Assessment questionnaire(MIDAS)(n=32,MD=-2.94,95%CI:-15.31 to 9.43,Z=0.47,P=0.64).The adverse reactions of rTMS were mild to moderate,and the patients were well tolerated and had high safety.Conclusion Repetitive transcranial magnetic stimulation can effectively decrease the frequency of headache attacks and the frequency of acute analgesic drug use in patients with chronic migraine,with fewer adverse reactions.
Repetitive transcranial magnetic stimulationChronic migraineProphylactic treatment