Brain Ray Gun Cures Migraines (Zap, Zap!)

I just couldn't resist that title. A more accurate title would have been "Transcranial Magnetic Stimulation Prevents Migraines From Progressing," but, when in doubt, err on the side of drama. And, I actually wasn't THAT far off, really. (Note: Ray gun above is not real (duh). Real device under the fold.)

As reported in Medical News Today , a handheld device which relies on transcranial magnetic stimulation (TMS) to deliver an mild electric current for about 1 millisecond is able to interrupt migraines from progressing to the headache stage. This is extremely useful clinically, as migraine sufferers often get "warning signs" which help them predict when a migraine is coming on. These signs may include sensitivity to light or sound, certain smells, hallucinations, dizziness, etc. If the TMS device is utilized at this stage, the migraine will not become a painful headache, which many people find debilitating.

The researchers, from Ohio State University Medical Center, treated 23 migraine patients with the TMS device. 69% had either no headache or very mild headache two hours after being zapped, 42% of the TMS group classed their lack of symptoms as excellent or very good. 48% of the placebo group reported in the same way, with just 26% reporting their lack of symptoms as excellent or very good.

(More on the study, TMS, and how it works below the fold!)

Furthermore, most of the TMS patients reported no noise sensitivity, more 50% reported no light sensitivity, and nausea symptoms fell 88%. Patients treated with a TMS look-a-like, a placebo, reported a 56% drop in nausea symptoms. This is quite interesting in itself as it highlights the power of the placebo effect---or the perception of improvement merely because you "think" you are getting therapeutic treatment, and therefore "feel" better. But, the device was significantly more effective, and no side-effects were experienced by any of the patients who received the TMS treatment.

The researchers then went on to see whether patients could treat themselves - use the TMS device on their own. This second study, with twelve volunteers, concluded that the TMS device is suitable for self-administration. Patients can use it on their own as soon as migraine symptoms start.

Haircut and a TMS, two bits?

What is TMS?
TMS draws upon the knowledge that the brain is an "electrical organ," and induced changes in electrical activity and magnetic fields will ultimately result in minor (or major, in the case of electro-shock therapy) changes in the brain. TMS rapidly changes (for a tiny fraction of time) the magnetic fields in the brain by electromagnetic induction OUTSIDE the skull (no need for surgery, or invasive therapy of any kind.) It is also a powerful tool for mapping out brain activity noninvasively, and can demonstrate causality. While fMRI shows the regions of the brain that are activated when a task is performed, that in itself is not PROOF that that region is required, but rather associated, with that task. But, TMS can complement fMRI; if activity in this associated region is suppressed with TMS and the subject performs WORSE on the task, it could provide much stronger evidence that the brain area in question is important in that task.

During TMS stimulation, a powerful magnet is held close to the patient's brain (frontal cortex in the case of migraines) and a magnetic pulse is delivered. A coil of wire is held to the head, which when energized by the discharge of a capacitor, introduces rapidly changing current flow. Over the long term this alters the biochemistry and firing patterns of the neurons in this ares, because neurons rely on polarization and electrical currents for excitation and synaptic change. This is hypothesized to result in changes in gene transcription and neurotransmitter regulation, and can affect associated areas of the brain to the one treated.

But in the case of migraines though, the response is immediate, rather than relying on eventual changes in genes and neurochemistry which takes weeks. This is fascinating to me, as it suggests that TMS therapy can interfere with improper blood flow and brain activity in real-time. This has amazing implications for individuals suffering from a variety of disorders of activity mis-regulations like epilepsy, ADD/ADHD, and, perhaps, autism.

Drawbacks? Not (yet) sold to the public, and cost from $50,000-$100,000. But, as with all niche medical devices, as the applications and technology improve, the price comes down. This is a technology to keep an eye on.

For more information, check out Open-rTMS.