Neuromodulation for Chronic Daily Headache

Magis, Delphine; Casillo, Francesco; Sebastianelli, Gabriele; Abagnale, Chiara; Cioffi, Ettore; Lenola, Davide Di; Lorenzo, Cherubino Di; Serrao, Mariano

doi:10.1007/s11916-022-01025-x

Cited by 21 publications

(23 citation statements)

References 132 publications

(167 reference statements)

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“…Of note, in a previous open-label study, a fatal event occurred in 1 of the 6 patients who underwent the procedure. Because of the possible serious adverse events, invasive stimulation of the posterior hypothalamus should only be considered in cases of failure of all pharmacological preventive treatments, used also in combination, and the extracranial invasive or noninvasive neurostimulation methods …”

Section: Management Of Chronic Cluster Headachementioning

confidence: 99%

“…Among procedural treatments, efficacy of occipital nerve major blocks and infraorbital and supraorbital nerve blocks have been described . There are also positive therapeutic effects of microvascular decompression of the trigeminal nerve root that have recently been confirmed in a larger population The largest study so far was an uncontrolled open-label prospective single-center study conducted between 2012 and 2020 to evaluate the efficacy and safety of trigeminal microvascular decompression in refractory chronic SUNCT or SUNA in patients with magnetic resonance imaging evidence of trigeminal neurovascular conflict ipsilateral to the pain side . The study group consisted of 47 patients of whom 31 had SUNCT and 16 had SUNA.…”

Section: Short-lasting Unilateral Neuralgiform Headache Attacksmentioning

confidence: 99%

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Management of Trigeminal Autonomic Cephalalgias Including Chronic Cluster

2023

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ImportanceTrigeminal autonomic cephalalgias (TACs) comprise a unique collection of primary headache disorders characterized by moderate or severe unilateral pain, localized in in the area of distribution of the first branch of the trigeminal nerve, accompanied by cranial autonomic symptoms and signs. Most TACs are rare diseases, which hampers the possibility of performing randomized clinical trials and large studies. Therefore, knowledge of treatment efficacy must be based only on observational studies, rare disease registries, and case reports, where real-world data and evidence play an important role in health care decisions.ObservationsChronic cluster headache is the most common of these disorders, and the literature offers some evidence from randomized clinical trials to support the use of pharmacologic and neurostimulation treatments. Galcanezumab, a monoclonal antibody targeting the calcitonin gene-related peptide, was not effective at 3 months in a randomized clinical trial but showed efficacy at 12 months in a large case series. For the other TACs (ie, paroxysmal hemicrania, hemicrania continua, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms), only case reports and case series are available to guide physicians in everyday management.Conclusions and RelevanceThe accumulation of epidemiologic, pathophysiologic, natural history knowledge, and data from case series and small controlled trials, especially over the past 20 years from investigators around the world, has added to the previously limited evidence and has helped advance and inform the treatment approach to rare TACs, which can be extremely challenging for clinicians.

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Section: Management Of Chronic Cluster Headachementioning

confidence: 99%

Section: Short-lasting Unilateral Neuralgiform Headache Attacksmentioning

confidence: 99%

Management of Trigeminal Autonomic Cephalalgias Including Chronic Cluster

2023

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“…Invasive treatments like DBS may only be effective after weeks of the stimulator being switched on, i.e. due more to an indirect neuromodulatory effect on an area/network connected to it than a direct effect (126). The role of the hypothalamus in the period of chronification is undoubtedly to be scaled down.…”

Section: Discussionmentioning

confidence: 99%

Pathophysiology of cluster headache: From the trigeminovascular system to the cerebral networks

Coppola,

Abagnale,

Sebastianelli

et al. 2024

Cephalalgia

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Background Despite advances in neuroimaging and electrophysiology, cluster headache’s pathogenesis remains unclear. This review will examine clinical neurophysiology studies, including electrophysiological and functional neuroimaging, to determine if they might help us construct a neurophysiological model of cluster headache. Results Clinical, biochemical, and electrophysiological research have implicated the trigeminal-parasympathetic system in cluster headache pain generation, although the order in which these two systems are activated, which may be somewhat independent, is unknown. Electrophysiology and neuroimaging have found one or more central factors that may cause seasonal and circadian attacks. The well-known posterior hypothalamus, with its primary circadian pacemaker suprachiasmatic nucleus, the brainstem monoaminergic systems, the midbrain, with an emphasis on the dopaminergic system, especially when cluster headache is chronic, and the descending pain control systems appear to be involved. Functional connection investigations have verified electrophysiological evidence of functional changes in distant brain regions connecting to wide cerebral networks other than pain. Conclusion We propose that under the impact of external time, an inherited misalignment between the primary circadian pacemaker suprachiasmatic nucleus and other secondary extra- suprachiasmatic nucleus clocks may promote disturbance of the body’s internal physiological clock, lowering the threshold for bout recurrence.

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“…Applications of non-invasive electrical stimulation span treatment of pain and headache (1, 2), depression, addiction, age related cognitive decline (3, 4), wound healing (5, 6), aesthetic uses (7), bioelectronic medicine, and drug delivery (8). Electrical therapy devices have become compoundingly complex (microelectronics, stretchable electronics, wireless connectivity, etc.)…”

Section: Mainmentioning

confidence: 99%

Wearable Disposable Electrotherapy

FallahRad,

Chaudhry,

Belali Koochesfahani

et al. 2023

Preprint

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We design and validate a novel electrotherapy platform, without any electronic components, using printed abundant environmentally-benign materials. Whereas existing electrotherapy devices use an independent power source and electronics to generate and control stimulation currents, our design eliminates the need for these components, reducing manufacturing complexity and costs. Our novel platform relies only on scalable manufacturing and environmentally-benign common materials. The disposable single-use platform is activated simply by placement on the body. A prescribed electrotherapy discharge is regulated by a novel electrochemical architecture. Production is scalable by relying only on additive manufacturing and low-cost materials, and tailored to any application in a flexible package (as discreet as adhesive bandages). The single-dose nature of this platform is a categorical shift from existing approaches with durable equipment that require programming and assembly to disposable electrodes for each use. Our Wearable Disposable Electrotherapy technology can be distributed like pharmacotherapy, with indications spanning neuromodulation of brain disorders, aesthetics, wound healing, transcutaneous drug delivery, and bioelectronic medicine.

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Neuromodulation for Chronic Daily Headache

Cited by 21 publications

References 132 publications

Management of Trigeminal Autonomic Cephalalgias Including Chronic Cluster

Management of Trigeminal Autonomic Cephalalgias Including Chronic Cluster

Pathophysiology of cluster headache: From the trigeminovascular system to the cerebral networks

Wearable Disposable Electrotherapy

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