Predictors of Quality of Life in Adults with Migraine After rTMS

Background: Migraine is a chronic neurological disorder associated with significant functional impairment and reduced quality of life (QoL). Repetitive transcranial magnetic stimulation (rTMS) represents a non-pharmacological treatment option, yet predictors of QoL improvement following rTMS remain poorly understood. Methods: In this exploratory observational study, 32 adults with migraine underwent 10–40 rTMS sessions. QoL was assessed at baseline and post-intervention using the WHOQOL-BREF and Migraine-Specific Quality of Life Questionnaire (Migraine-QoL). Anxiety, depression, headache impact, and disability were evaluated using HAMA, HAMD, HIT-6, and MIDAS. Changes in QoL were calculated as post-treatment minus baseline scores. Paired t-tests assessed pre–post changes, Spearman correlations explored associations with baseline variables, and linear regression identified independent predictors. Results: Both overall QoL and Migraine-QoL improved significantly following rTMS (p<0.001). Antipsychotic use was associated with greater improvement in overall QoL (p=0.026). Higher baseline HIT-6 and HAMA scores correlated with greater improvements in Migraine-QoL. In regression analyses, higher baseline headache severity and younger age independently predicted Migraine-QoL improvement, explaining 53.1% of the variance. Conclusions: rTMS was associated with meaningful QoL improvements in migraine. Baseline headache burden and age may help identify patients most likely to benefit. Larger controlled studies are needed to confirm these findings.