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Clinical Publications

Use of transcranial magnetic stimulation (TMS) and the eNeura device have been rigorously studied and documented in scientific and medical publications…



A Multicenter, Prospective, Single Arm, Open Label, Post-Market, Observational Study to evaluate the use of sTMS in reduction of Migraine Headache (ESPOUSE Study)

Starling AJ, Tepper SJ, Marmura MJ, Shamim EA, Robbins MS, Hindiya N, Charles AC, Goadsby PJ, Lipton RB, Silberstein SD, Gelfand AA, Chiacchierini RP and Dodick DW.  Cephalalgia. 2018. 0(0) I-II.  DOI: 10.1177/0333102418762525.

The objective of this clinical trial was to evaluate the efficacy and tolerability of sTMS for the preventive treatment of migraine. The primary effectiveness endpoint, mean reduction of headache days, was met and was statistically significant. Secondary effectiveness endpoints were all met: reduction in acute medication days, reduction in HIT-6 score and a reduction in total headache days of any pain intensity. sTMS was well tolerated. Based on the ESPOUSE study and a previous UK Study, the FDA cleared sTMS for the prophylactic treatment of migraine headache.


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Transcranial Magnetic Stimulation for Migraine Prevention in Adolescents: A Pilot Open-Label Study

Irwin SL, Qubty W, Allen E, Patniyot I, Goadsby PJ, Gelfand AA. Headache 2018. doi: 10.1111/head.13284

To assess the feasibility, tolerability, and patient acceptability of single-pulse transcranial magnetic stimulation (sTMS) for migraine prevention in adolescents in an open-label pilot study.

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Case Report of the Safety Assessment of Transcranial Magnetic Stimulation Use in a Patient with Cardiac Pacemaker: To Pulse or Not to Pulse?

Wei DY, Greenwood FS, Murgatroyd FD, Goadsby PJ.  Headache. 2018; 58:295-297.

We present a patient with chronic migraine with a cardiac pacemaker, who had tried unsuccessfully several migraine preventives with either poor efficacy or tolerability. With involvement of the cardiology team, we tested the effect of sTMS on her pacemaker and found it to be a safe and effective option for her.

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sTMS Blocks Cortical Spreading Depression by Suppressing Cortical Neuronal Firing and by Increasing the Threshold of Activation of the Occipital Cortex

Lloyd JO, Okine BN, Jones MG, Al-Kaisy A, Lambru G, McMahon SB, Andreou AP.  Abstract: 18th Congress of the International Headache Society; September 7-10, 2017; Vancouver, BC, Canada.

Abstract: This study aimed to investigate the cortical actions of sTMS in a migraine model. The data show that sTMS, when applied at intensities below the motor activation threshold suppresses spontaneous and glutamate-induced neuronal activity at the visual cortex and increases the eletrical threshold required for a CSD induction. Collectively, these finding suggest that sTMS reduces cortical excitability by increasing the threshold of activation of cortical neurons.

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Transcranial magnetic stimulation and potential cortical and trigeminothalamic mechanisms in migraine.

Andreou AP, Holland PR, Akerman S, Summ O, Fredrick J, Goadsby PJ. Brain. 2016;139(7):2002-2014. doi:10.1093/brain/aww118.

Abstract: The potential mechanisms of action of transcranial magnetic stimulation were investigated, using a trans-cortical approach, in preclinical migraine models. It was demonstrated that cortical spreading depression can be blocked in vivo using single pulse transcranial magnetic stimulation and may have a novel thalamocortical modulatory capacity that may explain the efficacy of magnetic stimulation in the treatment of migraine with and without aura.

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Single-pulse transcranial magnetic stimulation (sTMS) for the acute treatment of migraine: evaluation of outcome data for the UK post market pilot program.

Bhola R, Kinsella E, Giffin N, et al. J Headache Pain. 2015;16:535. doi:10.1186/s10194-015-0535-3.

Abstract: Migraine patients with and without aura were treated with sTMS over 12 weeks and reported significant pain relief along with a reduction in monthly headache days, demonstrating that sTMS may be a valuable addition to options for the treatment of both episodic and chronic migraine.

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Transcranial magnetic stimulation for migraine: a safety review.

Dodick DW, Schembri CT, Helmuth M, Aurora SK. Headache. 2010;50(7):1153-1163. doi:10.1111/j.1526-4610.2010.01697.x/abstract.

Summary: In an analysis of studies of single-pulse and repetitive TMS, potential and theoretical safety concerns of transcranial (TMS) are reviewed. Safety concerns associated with sTMS in the context of its use as a migraine treatment are specifically considered. It is concluded that the safety of sTMS in clinical practice is supported by biological, empirical, and clinical trial evidence and that it may offer a safe therapeutic alternative to the currently prescribed drugs for patients who suffer from migraine.

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Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial.

Lipton RB, Dodick DW, Silberstein SD, et al. The Lancet Neurology. 2010;9(4):373-380.\r\ndoi:http://dx.doi.org/10.1016/S1474-4422(10)70054-5

Summary: The efficacy and safety of a new portable sTMS device for acute treatment of migraine with aura were assessed in a randomised, double-blind, parallel-group, 2-phase, sham-controlled study at 18 centers in the USA. Early treatment resulted in increases freedom from pain at 2 hours and absence of pain at 24 and 48 hours after treatment.

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Use of single pulse TMS (sTMS) to treat migraine with medication overuse.

Bhola R, Kinsella E, Weatherby S, et al. Abstract, IHC 17th Congress of the International Headache Society; May 14–17, 2015; Valencia, Spain

Summary: In this study, neurologists advised reduction of triptan and OTC medications in tandem with regular sTMS therapy over a period of 3 months for selected migraine patients. Analyzing their results, they conclude that sTMS may be an effective bridge treatment for migraine patients with medication overuse.

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Comparison of effect size between active and placebo for single pulse transcranial magnetic stimulation (spTMS) versus triptans for the acute treatment of migraine.

Starling AJ, Dodick DW, Chiacchierini RP. Abstract, American Academy of Neurology’s 63rd Annual Meeting; April 9–16, 2011; Honolulu, HI.

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Treatment cost analysis of refractory chronic migraine patients in a UK NHS setting.

Ahmed F, Goadsby PJ, Bhola R, Reinhold T, Brüggenjürgen B. Abstract, IHC 17th Congress of the International Headache Society; May 14–17, 2015; Valencia, Spain.

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Single pulse transcranial magnetic stimulation (sTMS) as a non-drug treatment option for pregnant patients with migraine.

Bhola R, Giffin N, Ahmed F. Abstract, 2013 International Headache Congress; June 27–30, 2013; Boston, MA.

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Transcranial magnetic stimulation attentuates neuronal firing of trigeminothalamic neurons.

Andreou AP, Fredrick J, Goadsby PJ. Abstract, European Headache and Migraine Trust International Congress; September 20–23, 2012; London, UK.

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Transcranial magnetic stimulation for migraine: clinical effects.

Clarke BA, Upton ARM, Kamath MV, Al-Harbi T, Castellanos CM. J Headache Pain. 2006;7:341-346. doi:10.1007/s10194-006-0329-8.

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Transcranial magnetic stimulation in the treatment of migraine.

Lipton RB, Pearlman SH. Neurotherapeutics. 2010;7(2):204-212. doi:10.1016/j.nurt.2010.03.002.

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Transcranial magnetic stimulation (TMS) relieves migraine headache.

Mohammad YM, Kothari R, Hughes G, et al. Abstract, American Headache Society annual meeting; June 2006; Los Angeles, CA.

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Update of the UK post market pilot programme with single pulse transcranial magnetic stimulation (sTMS) for acute treatment of migraine.

Bhola R, Kinsella E, Ahmed F, Goadsby PJ. Abstract, 4th European Headache and Migraine Trust International Congress; September 18–21, 2014; Copenhagen, Denmark.

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Update of the UK post market pilot programme with single pulse transcranial magnetic stimulation (sTMS) for acute treatment of migraine.

Bhola R, Kinsella E, Goadsby PJ. Abstract, 56th Annual Meeting of the American Headache Society; June 26–29, 2014; Los Angeles, CA.

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Indication: The sTMS mini™ by eNeura® is indicated for the prevention and acute treatment of migraine.