Migraines are a type of sickness that is difficult to diagnose, whose symptoms affect the quality of life and the daily tasks of the affected person, resulting in momentary disability. Its pathophysiology is still imprecise, but the most accepted hypothesis is the neurological one explained by the dysfunction of the excitability of the cortical neurons - occurrence of a wave of occipital-frontal depolarization followed by a period of suppression of neuronal activity. The main treatment used is still pharmacological, but it can trigger a series of side effects that are difficult to tolerate, in addition to being unspecific. In this context, non-pharmacological therapies such as transcranial direct current stimulation (TDCS) and mindfulness have gained prominence for their low cost, safety and effectiveness. In view of the beneficial effects of combined mindfulness therapy and ETCC in disorders of the central nervous system, combined with the theoretical gap in clinical trials that investigate the use of these treatments in patients with migraines, we have chosen to divide this work into two chapters. The first chapter was dedicated to the scoping review of clinical trials aiming to compare the specific clinical results of ETCC of the main cortical targets used in migraines (primary motor - M1, primary visual - V1 and dorsolateral prefrontal - CPFDL). The analysis of the selected articles shows supremacy of the CPFDL stimulation points with regard to the decrease in pain intensity and V1 in terms of reducing the frequency of crises in this condition. The second chapter concerns the written article based on the randomized clinical trial (RCT) that we conducted associating ETCC with mindfulness in volunteers diagnosed with chronic migraine.. The objectives of this RCT were to assess whether such techniques were safe and effective when used together in patients with chronic migraines, to compare the degree of disability and the impact of headaches on activities in daily living, as well as the levels of mindfulness of the participants before and after the entire intervention was performed, in patients subdivided into groups of active ETCC and ETCC sham, both associated with mindfulness. After treatment, the active ETCC group combinated with the mindfulness showed better results in all outcomes. The sham group also combinated with the mindfulness showed improvements, but with smaller effect sizes compared to the active group. There was a significant difference in the analysis of interactions only in the case of post-treatment equivalent to the headache impact on the performance of daily activities, highlighting the active current group.

Migraine is a pathology whose symptoms directly affect the individual's personal and work life, jeopardizing the daily chores and social relationships momentarily. Considered difficult to diagnose, its pathophysiology is still imprecise, however, despite the several hypotheses to explain the genesis of the referred disease, the most accepted one considers that migraine consists of a dysfunction in the excitability of cortical neurons, which, in turn, promotes a wave of occipital-frontal depolarization, followed by a period of suppression of neuronal activity. Parallel to the studies that seek to explain the pathophysiological aspects of chronic migraine, another current of research presses to observe and understand how the neuronal activity of these patients is characterized, in order to support the construction of future therapeutic proposals. For this purpose, in the construction of this dissertation, the theoretical framework of the variables to be analyzed in the study (electroencephalographic records of alpha asymmetry, head movement patterns and emotional states) was initially carried out, laid down in the first chapter of the work, and then an observational cross-sectional study of brain and postural correlates was performed in patients with migraine who participated in a stress reduction program based on mindfulness. The objective was to evaluate the relationship between the clinical perception of pain in patients with migraine, as well as to establish possible neurophysiological signatures related to the pathological process, through electroencephalographic and head movement findings. Significant correlations were found between alpha wave power in the right and left frontal hemispheres, head movement and self- reports of the severity of migraine symptoms and the state of mindfulness in the participants. These preliminary results indicate that the frontal alpha power and head movements could function as biomarkers of migraine and mindfulness.

Cefaleias primárias são decorrentes de disfunção cerebral e incluem migrânea, cefaleia do tipo tensional, cefaleias trigêmino-autonômicas e outras. Diversos fatores podem desencadear crises de cefaleia, mas os odores, especialmente o perfume, estão associados à migrânea. Objetivos: Caracterizar a estimulação olfatória como fator desencadeante de crises de cefaleia e de diferenciação entre migrânea e outras cefaleias primárias. Sujeitos e Métodos: O estudo foi prospectivo, experimental, randomizado com comparação de grupos, realizado no período de março a junho de 2015. Foram convidados 158 voluntários (73 homens e 85 mulheres) diagnosticados com cefaleias primárias, de acordo com os critérios da International Classification of Headache Disorders, Third Edition (beta version) (ICHD-3β). O estudo foi realizado por dois examinadores; atribuiu-se ao primeiro, diagnosticar a presença e o tipo de cefaleia primária, enquanto o segundo foi responsável pela exposição dos voluntários ao odor e pelo registro dos efeitos dessa exposição. Resultados: Dos 158 voluntários com cefaleia, houve 72 (45,6%) casos de migrânea e 86 (54,4%) com outras cefaleias primárias. Dos 72 migranosos, 53 (73,6%) eram mulheres e 19 (26,4%), homens e dos 86 casos de outras cefaleias primárias, 32 (37,2%) eram mulheres e 54 (62,8%), homens. A idade dos voluntários com migrânea e com outras cefaleias primárias foi, respectivamente, 22,5±3,10 e 22,9±3,10 anos. Essas diferenças não foram significantes (tmédias=0,666; p=0,566). Nos dois grupos, houve diferença nas características da cefaleia (c2=4,132; p=0,046). O odor desencadeou cefaleia (25/72; 34,7%) e náusea (5/72; 6,9%) apenas nos voluntários com migrânea, correspondendo a 19,0% (30/158) da amostra e em nenhum com outras cefaleias primárias (χ²=43,78; p<0,001). A cefaleia ocorreu mais frequentemente associada à náusea (p=0,146) e de localização bilateral (p=0,002) nos migranosos que apresentaram cefaleia desencadeada por odor. A cefaleia foi desencadeada após 118,0±24,6 min e a náusea após 72,8±84,7 min da exposição ao odor. Conclusões: O odor desencadeou crises de cefaleia ou náusea apenas nos pacientes com migrânea. Portanto, cefaleia desencadeada por odores poderá ser considerada um fator de diferenciação entre migrânea e outras cefaleias primárias e esse gatilho parece muito específico da migrânea.