Transcranial magnetic stimulation for treating and preventing migraine

The Committee noted that there is uncertainty about the optimal dose of transcranial magnetic stimulation (TMS) for both treatment and prevention of migraine, and the optimal frequency of use for prevention.

The Committee noted variation among the published studies in the indications for TMS and the treatment parameters used. This variation made evaluation complex and underpinned the recommendation in 1.5 for future studies to include clear descriptions of indications and treatment regimens.

The Committee noted the absence of evidence on the safety of long-term use of TMS, although there are currently no reports of the procedure causing harm in the long term. The recommendation in 1.5 about documenting neurological disorders in the longer term is based on the lack of information about possible long-term effects of the procedure.

The Committee was advised that TMS treatment may have a particular role in the reduction or avoidance of drug therapy, either where preferred, or where contraindicated or best avoided (for example, in pregnancy).