Effectiveness of Cranio-Cervical Osteopathic Techniques in Combination with Transcranial Direct Current Stimulation (tDCS) for Migraine: A Randomized Controlled Trial
Abstract
Background Migraine is a leading cause of disability worldwide, often complicated by cervical dysfunction and central sensitization. Non-phamacological strategies such as transcranial direct current stimulation (tDCS) and osteopathic manual therapy show promise, but their combined efficacy remains underexplored. This study aims to evaluate the effectiveness of combining active tDCS with physiotherapy compared to sham tDCS plus physiotherapy in patients with chronic migraine. Methods A single-center, single-blind randomized controlled trial was conducted at Sri Aurobindo University, India. A total of 160 participants with chronic migraine were randomized into two groups: Experimental Group A (Active tDCS + Cranio-cervical osteopathic therapy) and Control Group B (sham tDCS + Cranio-cervical osteopathic therapy). Interventions were delivered over six weeks (18 sessions). The outcomes were pain intensity measured by the Visual Analogue Scale (VAS), headache frequency and duration, pressure pain threshold (PPT), balance (MiniBESTest), quality of life (SF-36), Migraine Disability Assessment Score (MIDAS), Pittsburgh Sleep Quality Index (PSQI), Migraine Symptom Severity Score (MSSS). Statistical analyses employed ANCOVA and linear mixed-effects models with false discovery rate correction. Results Compared with controls, GroupA demonstrated significantly greater reduction in VAS (= 2.10,
p <
0
.
001, d = 1.15), headache frequency (∆ = 1.85/week,
p <
0
.
001) and duration (∆ =9.45…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 160 participants or records.
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