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Effectiveness and Safety of Noninvasive Neuromodulation for Migraine Prevention: A Network Meta‐Analysis.

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Title: Effectiveness and Safety of Noninvasive Neuromodulation for Migraine Prevention: A Network Meta‐Analysis.
Authors: Feng, Quan (AUTHOR), Liu, Fang (AUTHOR), Li, Na (AUTHOR), Yu, Xiran (AUTHOR), Ning, Lu (AUTHOR), Li, Yichen (AUTHOR), Tan, Ge (AUTHOR), Chauhan, Anjali (AUTHOR)
Source: Acta Neurologica Scandinavica. 3/26/2026, Vol. 2026, p1-22. 22p.
Subjects: Migraine, Vagus nerve stimulation, Safety, Treatment effectiveness, Brain stimulation, Randomized controlled trials
Abstract: Background: Migraine, a common chronic neurovascular disorder, has a global incidence rate of approximately 14%. Limited evidence exists for clinical decision‐making related to migraine preventive treatment via noninvasive neuromodulation. To bridge this gap, we conducted a network meta‐analysis (NMA) aimed at comparing and ranking the efficacy and safety of diverse noninvasive neuromodulation treatments in preventing migraine. Methods: We systematically searched for randomized controlled trials (RCTs) in four databases and included the final articles through strict screening. Subsequently, we carried out data extraction and quality assessment. Then, an NMA (PROSPERO ID CRD42024617371) based on the frequentist model was performed. Finally, we drew conclusions based on the surface under the cumulative ranking curve (SUCRA) and the league table. Results: Twenty four RCTs involving 2347 patients were included. Although no modality significantly reduced monthly migraine days versus placebo (p > 0.05), percutaneous mastoid electrical stimulation (PMES) emerged as the most effective and safest intervention (SUCRA: 78.8%) compared with placebo in achieving a 50% responder rate (OR = 16.58, 95% CI: 5.17, 53.17) and reducing monthly acute antimigraine medication use (MD = −0.90, 95% CI: −1.28, −0.52). Noninvasive vagus nerve stimulation (nVNS) exhibited the best safety profile (SUCRA: 72.2%) when high‐risk trials were excluded. Conclusion: Among the noninvasive neuromodulation interventions discussed, PMES appears to be a favorable choice for migraine prevention, pending verification through cross‐regional investigations. And nVNS shows the best safety profile when high‐risk trials were excluded. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effectiveness and Safety of Noninvasive Neuromodulation for Migraine Prevention: A Network Meta‐Analysis.
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  Data: <searchLink fieldCode="AR" term="%22Feng%2C+Quan%22">Feng, Quan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liu%2C+Fang%22">Liu, Fang</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Na%22">Li, Na</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yu%2C+Xiran%22">Yu, Xiran</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ning%2C+Lu%22">Ning, Lu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Yichen%22">Li, Yichen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tan%2C+Ge%22">Tan, Ge</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chauhan%2C+Anjali%22">Chauhan, Anjali</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. 3/26/2026, Vol. 2026, p1-22. 22p.
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  Data: <searchLink fieldCode="DE" term="%22Migraine%22">Migraine</searchLink><br /><searchLink fieldCode="DE" term="%22Vagus+nerve+stimulation%22">Vagus nerve stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Safety%22">Safety</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+stimulation%22">Brain stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background: Migraine, a common chronic neurovascular disorder, has a global incidence rate of approximately 14%. Limited evidence exists for clinical decision‐making related to migraine preventive treatment via noninvasive neuromodulation. To bridge this gap, we conducted a network meta‐analysis (NMA) aimed at comparing and ranking the efficacy and safety of diverse noninvasive neuromodulation treatments in preventing migraine. Methods: We systematically searched for randomized controlled trials (RCTs) in four databases and included the final articles through strict screening. Subsequently, we carried out data extraction and quality assessment. Then, an NMA (PROSPERO ID CRD42024617371) based on the frequentist model was performed. Finally, we drew conclusions based on the surface under the cumulative ranking curve (SUCRA) and the league table. Results: Twenty four RCTs involving 2347 patients were included. Although no modality significantly reduced monthly migraine days versus placebo (p > 0.05), percutaneous mastoid electrical stimulation (PMES) emerged as the most effective and safest intervention (SUCRA: 78.8%) compared with placebo in achieving a 50% responder rate (OR = 16.58, 95% CI: 5.17, 53.17) and reducing monthly acute antimigraine medication use (MD = −0.90, 95% CI: −1.28, −0.52). Noninvasive vagus nerve stimulation (nVNS) exhibited the best safety profile (SUCRA: 72.2%) when high‐risk trials were excluded. Conclusion: Among the noninvasive neuromodulation interventions discussed, PMES appears to be a favorable choice for migraine prevention, pending verification through cross‐regional investigations. And nVNS shows the best safety profile when high‐risk trials were excluded. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – SubjectFull: Safety
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      – SubjectFull: Treatment effectiveness
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              Text: 3/26/2026
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