The efficiency of pulsed electromagnetic field in refractory migraine headaches: a randomized, single-blinded, placebo-controlled, parallel group

Boshra Hatef, Fahime Hashemirad, Gholam Hossein Meftahi, Leila Simorgh, Soodeh Razeghi Jahromi, Forough Rahimi, Mansoureh Togha


Background: The study attempts to investigate the effect of PEMF therapy on Refractory Migraines (RM), both those which were related and those which were not related to menstrual cycle, in a randomized, single blind, placebo-controlled study.

Methods: The study attempts to investigate the effect of PEMF therapy on Refractory Migraines (RM), both those which were related and those which were not related to menstrual cycle, in a randomized, single blind, placebo-controlled study.

Results: There was a significant improvement for the active group in terms of their headache days, durations and work-loss hours due to headache compared to the placebo group after 2 weeks. The added results of the assessment of the active group indicated a significant improvement in the days and duration of headaches, work-loss hours and number of medications even after a following 4-8-month period. Headache intensity and the amount of medication used for headache were reduced only in RM patients that had headaches which were not related to their menstrual cycles.

Conclusions: PEMF (10 Hz, 4-5mT) can be considered as a beneficial and persistent prophylactic treatment option for refractory migraine.


Refractory migraine, Pulsed electromagnetic field therapy, Randomized clinical trial

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Negro A, D'Alonzo L, Martelletti P. Chronic migraine: comorbidities, risk factors, and rehabilitation. Intern Emerg Med. 2010;5(1):S13-9.

Valade D. Chronic migraine. Rev Neurol (Paris). 2013;169(5):419-26.

Lewczuk B, Redlarski G, Ak Zi A. Influence of Electric, Magnetic, and Electromagnetic Fields on the Circadian System: Current Stage of Knowledge. BioMed Research International. 2014;2014:13.

Peterlin BL, Calhoun AH, Siegel S, Mathew NT. Rational Combination Therapy in Refractory Migraine. Headache: The Journal of Head and Face Pain. 2008;48(6):805-19.

Irimia P, Palma JA, Fernandez-Torron R, Martinez-Vila E. Refractory migraine in a headache clinic population. BMC Neurol. 2011;11:94.

Ferrari MD. Migraine genetics: a fascinating journey towards improved migraine therapy. Headache. 2008;48(5):697-700.

Aurora SK, Barrodale PM, Tipton RL, Khodavirdi A. Brainstem dysfunction in chronic migraine as evidenced by neurophysiological and positron emission tomography studies. Headache. 2007;47(7):996-1003.

May A. The window into headache research: what have we learned from functional and structural neuroimaging. Schmerz. 2010;24(2):130-6.

Denuelle M, Fabre N, Payoux P, Chollet F, Geraud G. Posterior cerebral hypoperfusion in migraine without aura. Cephalalgia. 2008;28(8):856-62.

Leone M, Proietti CA, Mea E, Curone M, Tullo V, Casucci G. Functional neuroimaging and headache pathophysiology: new findings and new prospects. Neurol Sci. 2007;28(2):S108-13.

Sand T. Electroencephalography in migraine: a review with focus on quantitative electroencephalography and the migraine vs. epilepsy relationship. Cephalalgia. 2003;23(1):5-11.

Olesen J, Friberg L, Olsen TS, Iversen HK, Lassen NA, Andersen AR. Timing and topography of cerebral blood flow, aura, and headache during migraine attacks. Annals of Neurology. 1990;28(6):791-8.

Coppola G, Di Lorenzo C, Schoenen J, Pierelli F. Habituation and sensitization in primary headaches. J Headache Pain. 2013;14(1):65.

Bronfort G, Nilsson N, Haas M, Evans R, Goldsmith CH, Assendelft WJ. Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev. 2004(3):CD001878.

Pelka RB, Jaenicke C, Gruenwald J. Impulse magnetic-field therapy for migraine and other headaches: a double-blind, placebo-controlled study. Adv Ther. 2001;18(3):101-9.

Sherman RA, Acosta NM, Robson L. Treatment of migraine with pulsing electromagnetic fields: a double-blind, placebo-controlled study. Headache. 1999;39(8):567-75.

Vincent W, Andrasik F, Sherman R. Headache treatment with pulsing electromagnetic fields: a literature review. Appl Psychophysiol Biofeedback. 2007;32(3-4):191-207.

Pilla A, Fitzsimmons R, Muehsam D, Wu J, Rohde C, Casper D. Electromagnetic fields as first messenger in biological signalling: Application to calmodulin-dependent signaling in tissue repair. Biochim Biophys Acta. 2011;1810(12):1236-45.

Yu-Hong Z, Yong Z, Tong-Jun Z, Ya-Fei C, Chang-Qing Y. Model for Influences of Magnetic Fields on Intracellular Calcium Oscillations. Communications in Theoretical Physics. 2009;52(1):168.

McKay JC, Prato FS, Thomas AW. A literature review: the effects of magnetic field exposure on blood flow and blood vessels in the micro-vasculature. Bioelectromagnetics. 2007;28(2):81-98.

Habash. Bio Effects and Therapeutic Applications of Electromagnetic Energy. New York: Hardcover. 2008.

Tong JJ. Mitochondrial delivery is essential for synaptic potentiation. Biol Bull. 2007;212(2):169-75.

Sieron A, Labus L, Nowak P, Cieslar G, Brus H, Durczok A. Alternating extremely low frequency magnetic field increases turnover of dopamine and serotonin in rat frontal cortex. Bioelectromagnetics. 2004;25(6):426-30.

Shafiei S, Firoozabadi S, Rasoulzadeh Tabatabaie K, Ghabaee M. EEG changes during exposure to extremely low frequency magnetic field on a small area of brain. Koomesh. 2011;12(2):167-74.

Cvetkovic D, Cosic I. Alterations of human electroencephalographic activity caused by multiple extremely low frequency magnetic field exposures. Med Biol Eng Comput. 2009;47(10):1063-73.

Silberstein S, Tfelt-Hansen P, Dodick DW, Limmroth V, Lipton RB, Pascual J. Guidelines for controlled trials of prophylactic treatment of chronic migraine in adults. Cephalalgia. 2008;28(5):484-95.

Pryse-Phillips WE, Dodick DW, Edmeads JG, Gawel MJ, Nelson RF, Purdy RA. Guidelines for the nonpharmacologic management of migraine in clinical practice. Canadian Headache Society. CMAJ. 1998;159(1):47-54.

Silberstein SD, Hutchinson SL. Diagnosis and treatment of the menstrual migraine patient. Headache. 2008;48(3):S115-23.

Markov MS. Expanding Use of Pulsed Electromagnetic Field Therapies. Electromagnetic Biology and Medicine. 2007;26(3):257-74.

Yamaguchi-Sekino S, Sekino M, Ueno S. Biological effects of electromagnetic fields and recently updated safety guidelines for strong static magnetic fields. Magn Reson Med Sci. 2011;10(1):1-10.

Funk RH, Monsees T, Ozkucur N. Electromagnetic effects - From cell biology to medicine. Prog Histochem Cytochem. 2009;43(4):177-264.

Ghorbani A, Chitsaz A. Comparison of validity and reliability of the Migraine disability assessment (MIDAS) versus headache impact test (HIT) in an Iranian population. Iran J Neurol. 2011;10(3-4):39-42.

Cook CM, Saucier DM, Thomas AW, Prato FS. Changes in human EEG alpha activity following exposure to two different pulsed magnetic field sequences. Bioelectromagnetics. 2009;30(1):9-20.

Robertson JA, Juen N, Theberge J, Weller J, Drost DJ, Prato FS. Evidence for a dose-dependent effect of pulsed magnetic fields on pain processing. Neurosci Lett. 2010;482(2):160-2.

Sherman RA, Robson L, Marden LA. Initial exploration of pulsing electromagnetic fields for treatment of migraine. Headache. 1998;38(3):208-13.

Touitou Y, Selmaoui B. The effects of extremely low-frequency magnetic fields on melatonin and cortisol, two marker rhythms of the circadian system. Dialogues Clin Neurosci. 2012;14(4):381-99.

Bjork M, Sand T. Quantitative EEG power and asymmetry increase 36 h before a migraine attack. Cephalalgia. 2008;28(9):960-8.

Shafiei SA, Firoozabadi SM, Rasoulzadeh Tabatabaie K, Ghabaee M. Study of the frequency parameters of EEG influenced by zone-dependent local ELF-MF exposure on the human head. Electromagn Biol Med. 2012;31(2):112-21.

Bell GB, Marino AA, Chesson AL. Frequency-specific responses in the human brain caused by electromagnetic fields. J Neurol Sci. 1994;123(1-2):26-32.

Bauréus Koch CLM, Sommarin M, Persson BRR, Salford LG, Eberhardt JL. Interaction between weak low frequency magnetic fields and cell membranes. Bioelectromagnetics. 2003;24(6):395-402.

Blackman CF, Kinney LS, House DE, Joines WT. Multiple power-density windows and their possible origin. Bioelectromagnetics. 1989;10(2):115-28.

Wade B. A Review of Pulsed Electromagnetic Field (PEMF) Mechanisms at a Cellular Level: A Rationale for Clinical Use. American Journal of Health Research. 2013;1(3):51-5.

Ding GR, Li KC, Wang XW, Zhou YC, Qiu LB, Tan J. Effect of electromagnetic pulse exposure on brain micro vascular permeability in rats. Biomed Environ Sci. 2009;22(3):265-8.

Chiapparini L, Ferraro S, Grazzi L, Bussone G. Neuroimaging in chronic migraine. Neurol Sci. 2010;31(1):S19-22.

May A. A review of diagnostic and functional imaging in headache. J Headache Pain. 2006;7(4):174-84.

De Marinis M. Migraine and autonomic nervous system function: a population-based, case-control study. Neurology. 2003;61(3):424-5.

Schurks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ. 2009;339:b3914.

Olesen J, Burstein R, Ashina M, Tfelt-Hansen P. Origin of pain in migraine: evidence for peripheral sensitisation. Lancet Neurol. 2009;8(7):679-90.