Transcranial Magnetic Stimulation in Episodic Migraine (Magnet-EM)

Migraine patients according to International Headache Society criteria will be allocated randomly into two treatment arms. One group will receive active rTMS and another group will receive sham rTMS for treatment phase (5 sessions). Assessment will be made at baseline, month 1, month 2 and month 3 post-treatment.

Inclusion criteria

• Males or females aged 18 to 60 years of age.
• Subjects fulfilling criteria for episodic migraine as per the Third Edition of The International Headache Society (ICHD-3) for at least 1 year.
• Frequency of migraine attacks 2-8 times per month with less than 15 headache days per month for at least 3 months prior to screening.
• Demonstrated compliance with the headache diary during the run-in period by entry of headache data on a minimum of 24/30 days (80% compliance).
• A signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study including any known and potential risks and available alternative treatments.

Exclusion criteria

• Patients with previous history of rTMS treatment.
• Onset of headache at more than 50-year-old.
• Headache with red flags symptoms that may suggest organic secondary headaches.
• Pregnant or lactating women.
• Patients with contraindications to TMS such as metallic implant and pacemaker based on the Screening 13-item Questionnaire for rTMS candidate.
• Patients with medical conditions such severe hypertension, infections, malignancy, cardiovascular and cerebrovascular disease, epilepsy degenerative central nervous system diseases, renal failure, hepatic failure, bleeding diathesis and serious mental illness.