Francesca Puledda1, Peter J Goadsby2. 1. Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College (F. Puledda). 2. Headache Group, NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, United Kingdom.
Abstract
OBJECTIVE: To review current neuromodulation treatments available for migraine therapy, both in the acute and preventive setting. METHODS: The published literature was reviewed for studies reporting the effects of different neuromodulation strategies in migraine with and without aura. The use of non-invasive: single pulse transcranial magnetic stimulation, non-invasive vagal nerve stimulation, supraorbital nerve stimulation, and transcranial direct current stimulation, as well as invasive methods such as occipital nerve stimulation and sphenopalatine ganglion stimulation, are assessed. RESULTS: The available evidence shows that non-invasive techniques represent promising treatment strategies, whereas an invasive approach should only be used where patients are refractory to other preventives, including non-invasive methods. CONCLUSIONS: Neuromodulation is emerging as an exciting approach to migraine therapy, especially in the context of failure of commonly used medicines or for patients who do not tolerate common side effects. More studies with appropriate blinding strategies are needed to confirm the results of these new treatment opportunities.
OBJECTIVE: To review current neuromodulation treatments available for migraine therapy, both in the acute and preventive setting. METHODS: The published literature was reviewed for studies reporting the effects of different neuromodulation strategies in migraine with and without aura. The use of non-invasive: single pulse transcranial magnetic stimulation, non-invasive vagal nerve stimulation, supraorbital nerve stimulation, and transcranial direct current stimulation, as well as invasive methods such as occipital nerve stimulation and sphenopalatine ganglion stimulation, are assessed. RESULTS: The available evidence shows that non-invasive techniques represent promising treatment strategies, whereas an invasive approach should only be used where patients are refractory to other preventives, including non-invasive methods. CONCLUSIONS: Neuromodulation is emerging as an exciting approach to migraine therapy, especially in the context of failure of commonly used medicines or for patients who do not tolerate common side effects. More studies with appropriate blinding strategies are needed to confirm the results of these new treatment opportunities.
Authors: Miguel Puche-Torres; Arantxa Blasco-Serra; Ana Campos-Peláez; Alfonso A Valverde-Navarro Journal: J Anat Date: 2017-09-28 Impact factor: 2.610
Authors: David Yarnitsky; David W Dodick; Brian M Grosberg; Rami Burstein; Alon Ironi; Dagan Harris; Tamar Lin; Stephen D Silberstein Journal: Headache Date: 2019-05-09 Impact factor: 5.887