Again, Mohammad cautions that larger, controlled studies are needed to determine how effective the treatment will be for migraines. This is especially important because the placebo effect can be strong in clinical trials of pain treatments. Mohammad is planning such a study in collaboration with Neuralieve, which has developed an even smaller portable TMS that will be used in the trial. Mohammed and doctors from several other medical centers will have about 150 patients try out the device or a placebo at home. “That’s the main goal – for patients to use this at home,” Mohammad says. (He adds that he has no financial interest in the company.)
Andrew Hershey, professor of pediatrics and neurology and director of the Headache Center at Cincinnati Children’s Hospital Medical Center, says that treating migraines with TMS is “very interesting from a conceptual standpoint,” but adds that the recent study doesn’t indicate how widely applicable this technology might be.
The findings might also help scientists understand the source of migraines. Swelling blood vessels were once believed to cause migraines by stimulating nerves in the pain center of the brain. According to an alternative theory growing in acceptance, migraines may be partly the result of a wave of electrical activity spreading from the back to front of the brain, and finally activating nerves in the pain center. The electrical current created by TMS is thought to intercept the wave, pre-empting the pain.