Abstract
PURPOSE: Non-invasive brain stimulation (NIBS) has shown promising potential in the treatment of migraine; however, its short- and long-term efficacy remains uncertain. This meta-analysis evaluated the effects of NIBS on multiple migraine-related clinical outcomes in both short- and long-term follow-ups. METHODS: This PRISMA-compliant review (PROSPERO: CRD42024529488) included RCTs on NIBS for migraine. A comprehensive search was conducted in PubMed, Scopus, The Cochrane, EMBASE, Web of Science, CNKI, and VIP up to April 11, 2024. Outcomes consisted of headache frequency, pain intensity, duration, analgesic intake, and adverse effects. Analyses used RevMan 5.3 and STATA 17.0. RESULTS: Thirteen studies (596 participants) were included. In terms of short-term outcomes, NIBS significantly reduced headache frequency (SMD = -1.47, 95% CI: -2.13 to -0.82) and pain intensity (SMD = -2.09, 95% CI: -3.36 to -0.83). During long-term follow-up, significant effects were still observed at <3 months (headache frequency: SMD = -1.13, 95% CI: -1.90 to -0.35; pain intensity: -0.66 95% CI: -1.02 to -0.30) and at 6-12 months (headache frequency: SMD = -3.95, 95% CI: -7.44 to -0.45; pain intensity: SMD = -2.55 95% CI: -4.73 to -0.36, with no significant improvements at 3-6 months. NIBS also provided short-term benefits in pain duration and analgesic use. Adverse event rates did not differ between groups. Meta-regression linked target and device to short-term efficacy. CONCLUSION: NIBS is an effective, preventive, and safe treatment for migraine but its long-term efficacy is not evident.