Transcranial magnetic stimulation in the treatment of chronic tension-type headache: theory and practice

Annotation. Tension-type headache (TTH) is the most common type of primary headache, and its chronic form significantly reduces patients’ quality of life and is challenging to treat. The aim of this review article is to analyze a novel treatment method – transcranial magnetic stimulation (TMS) – and to evaluate its effectiveness in managing chronic tension-type headache (CTTH). A literature search was conducted using high-impact databases, with the keywords «tension-type headache» and «transcranial magnetic stimulation». Additionally, recommendations from the British Association for the Study of Headache (BASH) were reviewed. Based on the analysis of studies conducted over the past 10 years, evidence suggests a positive effect of TMS in the treatment of CTTH. A significant reduction in headache intensity was observed, measured by the Numerical Rating Scale (NRS), where 0 represents no pain and 10 indicates unbearable pain. Notably, the NRS scores decreased from 5 to 1 after treatment. Moreover, an increase in nociceptive threshold levels was reported, indicating reduced pain sensitivity. Patients also reported a decrease in headache frequency and an improvement in general well-being and quality of life, including reduced anxiety symptoms and enhanced psychological condition. In conclusion, the subjective and objective indicators analyzed in this review support the effectiveness of low-frequency TMS in treating chronic tension-type headache. Further research is warranted to explore the broader potential of TMS and to facilitate its wider adoption, particularly in Ukraine.