Therapeutic magnetic stimulation in migraine is widely discussed. Known as the migraine zapper, a transcranial magnetic stimulator became an FDA approved investigational medical device. But what about other external stimulation techniques, like electrical currents or light flashes? Should we invent migraine frizzlers and migraine scintillators, too, or is that all fringe science?

The application of transcranial stimulation at the beginning of a migraine attack may abort the attack or reduce its severity significantly for same patients.  This is tested in a randomized, sham stimulation controlled investigation to assess the safety and to demonstrate that the method is effective as an add-on therapy in reducing attacks.

I think the idea is great. However, more important than the actual device is, to my mind, the stimualtion technique, i.e., the software that comes with the device. Like the very same computer (hardware) can run different operating systems, such as Windows, Mac, or Linux (software), the migraine zapper can be programmed in many different ways. Software can make a huge difference, as we all know.

Migraine frizzler and migraine scintillator

We might even investigate other devices that utilize other stimulation pathways into the brain.  Animal data (Liebetanz et al. Neurosci. Lett. 398, 2006) suggests that anodal transcranial direct current stimulation (tDCS)—by increasing cortical excitability—increases the probability of migraine attacks even beyond the end of its application.  Techniques adopted from chaos control can predict by which means it is possible to reverse the effect and abort an attack (Dahlem et al., Chaos 18, 2008). The tDCS-based device could be called the migraine frizzler instead of zapper. Even simpler would be to use a flashing light with certain good frequencies, the migraine scintillator. Here, too, we know spatial and temporal frequencies to increase cortical excitability. One can even elicte a migraine attack using light flashes. I firmly believe that it could work both ways, that we can also abort an attack or reduce its severity by external stimulations.

For any such device, my vision is a strategy I often have paraphrased as

From bifurcation to bench and bedside.

I want to understand neurological diseases, such as migraine but also stroke and epilepsies, as emergent transient states close to nonequilibrium phase transitions in the brain. Such transitions are in nonlinear dynamics called bifurcations.

Once we understand the theoretical concepts in terms of bifurcation theory, this should tell us how to program devices like the one shown in the video.

As Vivien Williams said in the video: 

It's like something you'd see on Star Trek

But I guess we still need at least a five-year mission: to explore strange new therapies; to boldly go where no man has gone before. This can probably only be done by a multi-center international group of clinical and basic scientists working together on migraine and feedback therapy.