Add-on Theta Burst Stimulation for Treatment-resistant Depression with Migraine

Background: Growing interest in using of repetitive transcranial magnetic stimulation (rTMS) to treat neurological and psychiatric diseases is emerging. A novel form of rTMS called theta burst stimulation (TBS) has been recently developed. To our knowledge, little information has been reported on TBS to treat migraine. Case report: We gave a two-week course of TBS to a 46-year-old woman with migraine and treatment-resistant depression. The patient remained on her ongoing antidepressant during TBS therapy. After the treatment, her depression was improved. The scores of the Hamilton Rating Scale for Depression (HAMD), the Hamilton Rating Scale for Anxiety (HAMA) and Beck Depression Inventory (BDI) were decreased from the pre-treatment baselines by 25%, 21% and 19%, respectively. According to her formal migraine diary, the intensity and frequency of her migraine attacks were improved by 25% and 71%, respectively. Conclusion: This case report suggests that rTMS (and specifically TBS) might provide a potential nonpharmacologic therapy for patients with both depression and migraine.