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Transcranial magnetic stimulation and potential cortical and trigeminothalamic mechanisms in migraine

Research output: Contribution to journalArticlepeer-review

Anna P. Antreou, Philip R. Holland, Simon Akerman, Oliver Summ, Joe Fredrick, Peter J. Goadsby

Original languageEnglish
Pages (from-to)2002-2014
Number of pages13
Issue number7
Early online date30 May 2016
Accepted/In press27 Mar 2016
E-pub ahead of print30 May 2016
Published1 Jul 2016


  • Transcranial magnetic stimulation and_ANDREOU_Accepted 27Mar2016_GOLD VoR

    Transcranial_magnetic_stimulation_and_ANDREOU_Online_30May2016_GOLD_VoR.pdf, 675 KB, application/pdf

    Uploaded date:12 Aug 2016

    Version:Final published version

    Licence:CC BY-NC

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits
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King's Authors


A single pulse of transcranial magnetic stimulation has been shown to be effective for the acute treatment of migraine with and without aura. Here we aimed to investigate the potential mechanisms of action of transcranial magnetic stimulation, using a transcortical approach, in preclinical migraine models. We tested the susceptibility of cortical spreading depression, the experimental correlate of migraine aura, and further evaluated the response of spontaneous and evoked trigeminovascular activity of second order trigemontothalamic and third order thalamocortical neurons in rats. Single pulse transcranial magnetic stimulation significantly inhibited both mechanical and chemically-induced cortical spreading depression when administered immediately post-induction in rats, but not when administered preinduction, and when controlled by a sham stimulation. Additionally transcranial magnetic stimulation significantly inhibited the spontaneous and evoked firing rate of third order thalamocortical projection neurons, but not second order neurons in the trigeminocervical complex, suggesting a potential modulatory effect that may underlie its utility in migraine. In gyrencephalic cat cortices, when administered post-cortical spreading depression, transcranial magnetic stimulation blocked the propagation of cortical spreading depression in two of eight animals. These results are the first to demonstrate that cortical spreading depression can be blocked in vivo using single pulse transcranial magnetic stimulation and further highlight a novel thalamocortical modulatory capacity that may explain the efficacy of magnetic stimulation in the treatment of migraine with and without aura.

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