P068 Acute treatment of migraine attacks using transcranial alternating stimulation at home

Objective Our study aimed to investigate the efficacy of low intensity high frequency transcranial alternating current stimulation (tACS) that was suggested to decrease cortical excitability, as domicile acute treatment option in patients with migraine. Method 40 patients were recruited in this double-blind, placebo-controlled study and were assigned to receive either active or sham stimulation. After the training in the clinic the patients were instructed to treat maximum 5 migraine attacks during 8 weeks at home using a preprogrammed stimulator. The intensity of the active stimulation was 0.4 mA and the frequency 140 Hz. The stimulation duration was 10 min applied over the visual cortex, with the return electrode placed at the vertex. The primary endpoint of the study was the number of terminated attacks 2 h post-stimulation. Results 25 patients completed the study, 15 in the acute and 10 in the sham group. Altogether 101 migraine attacks were treated. In the active group the number of terminated migraine attacks were significantly higher (19.7%) than in the sham group (2.5%) (without acute medication). Generally, the perceived pain after acute stimulation was significantly less for 8 h poststimulation, compared to the pain values in the sham group. Conclusion Our results indicate that acute treatment with tACS over the visual cortex might be able to terminate the migraine attacks, probably by modifying cortical excitability or oscillatory activity. However, the high drop-out rate suggests that this method is might not be ready for home-application.