RÉSUMÉ
Objective:To study the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in migraine without aura.Methods:A prospective sutdy was conducted; 74 patients with migraine without aura had definite diagnosis in our hospital from September 2019 to November 2020 were chosen and divided into hrTMS treatment group ( n=39) and control group ( n=35) by random number method. Patients in the hrTMS treatment group were treated with hrTMS once per d; the stimulation frequency was 20 Hz, each stimulus consisted of 20 sequences, and the amount of stimulus was 500 pulses; the treatment lasted for 6 d was as a course of treatment, and the next course of treatment was conducted at an interval of 1 d; a total of 4 courses of treatment was given. Patients in the control group were treated with pseudo-stimulation; treatment frequency was the same as above. Patients in the 2 groups were given oral conventional migraine drug (celecoxib, 0.2 g per time) according to the demands for analgesia (visual analog scale [VAS] scores≥4). The evoked potential N100 amplitudes and therapeutic effects 1, 2, and 4 weeks after treatment were evaluated and compared between the 2 groups; the occurrence of adverse reactions was observed. Results:There were significant differences in VAS scores and N100 amplitudes at each time point before and after treatment in the hrTMS treatment group ( P<0.05); the VAS scores decreased with time, while the N100 amplitudes increased with time. At 2 and 4 weeks after treatment, patients in the hrTMS treatment group had significantly lower VAS scores and statistically higher N100 amplitudes than those in the control group ( P<0.05). As compared with that in hrTMS treatment group before treatment and that in the control group at the same time point, the average days of headache per month in the hrTMS treatment group 4 weeks after treatment was significantly decreased ( P<0.05). No epileptic seizure, hearing loss, scalp burn or other adverse reactions occurred in the 2 groups after treatment. After treatment, there was no statistical significance in the incidence of dizziness, head discomfort, tinnitus or other adverse reactions between the 2 groups ( P>0.05). Conclusion:Long course of hrTMS can effectively improve the pain degree of patients with migraine without aura, and reduce the number of headache attacks, without obvious side effects, which is worthy of clinical application.