Neurostimulation for the treatment of chronic migraine and cluster headache

Cvetković, Vlasta Vuković; Jensen, Rigmor Højland

doi:10.1111/ane.13034

Cited by 26 publications

(31 citation statements)

References 79 publications

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“…Neuromodulatory approaches like non-invasive vagus nerve stimulations (14), Sphenopalatine Ganglion Stimulation (15), Percutaneous Bioelectric Current Stimulation (16) or Greater Occipital Nerve blocks (17) are increasingly used for patients in whom systemic pharmacotherapy is ineffective or contraindicated (18). Applying neuromodulatory treatments requires exact knowledge of the anatomical structures and pain topography relevant for CH.…”

Section: Background and Aimmentioning

confidence: 99%

“…The top 10 frequencies for ventral points are: 12,18,19,11,25,17,10,24,5,20. The top 10 frequencies for dorsal points are: 34, 40, 35, 39, 33, 32, 42, 44 ,38, 43.…”

Section: Peakmentioning

confidence: 99%

“…Pain location frequency is mainly congruent with onset (in and around the eye), except for dorsal points. Signi cant differences compared to radiation are reported for: (peri) orbital (5,11,12,18,19), frontal (10) and temporal (25) pain locations. (Fig.…”

Section: Peakmentioning

confidence: 99%

“…The top 10 ventral points are: 21,26,24,29,25,30,12,11,19,18. The top 10 dorsal points are: 35, 40, 36, 44, 34, 43, 39, 42, 38, 37.…”

Section: Radiationmentioning

confidence: 99%

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Phase Specific Pain Localization in Cluster Headache Patients.

Schröder¹,

Gaul²,

Drabik³

et al. 2020

Preprint

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Background and Objective:Applying local treatments like neuromodulation or injections for cluster headache, requires exact knowledge of the anatomical structures and pain topography. However studies with emphasis on exact pain localization are rare although local treatments are increasingly used for patients in whom systemic pharmacotherapy is ineffective or contraindicated. Here, survey results with emphasis on exact pain location in cluster headache attacks for onset of pain, peak pain and radiation of pain, are presented. Methods: Data from 631 respondents were collected for 23 months using an online survey composed of 117 questions on pain location, epidemiology, and clinical features. 5260 datapoints on 44 pain locations were analyzed.Results: There is a periorbital concentration of pain during onset and peak phases of attacks. Pain locations outside the periorbital region were reported more frequently during radiation when compared to the onset and peak of attacks. Dorsal (occipital/nuchal) pain is more frequent during onset and radiation compared to peak: onset pain (13%) vs. peak pain (6%), p < 0,001. Pain radiation (22%) vs. peak pain (6%), p < 0,001. There is no significant difference in dorsal pain frequencies for pain radiation (22%) vs. onset (13%), p = 0,552. Furthermore, single pain spots differ significantly in frequency during the three attack phases.Conclusions: Analysis of the pain location data shows phase specific frequencies and distributions of pain location during the three stages of a cluster headache attack. Single pain spots differ significantly in frequency during the three attack phases. Dorsal pain is more frequent during onset and radiation, compared to peak. Extra-orbital pain locations are more frequent during pain radiation. These findings will help to better understand cluster headache and might help to identify further target structures for local treatments.

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Section: Background and Aimmentioning

confidence: 99%

“…The top 10 frequencies for ventral points are: 12,18,19,11,25,17,10,24,5,20. The top 10 frequencies for dorsal points are: 34, 40, 35, 39, 33, 32, 42, 44 ,38, 43.…”

Section: Peakmentioning

confidence: 99%

Section: Peakmentioning

confidence: 99%

“…The top 10 ventral points are: 21,26,24,29,25,30,12,11,19,18. The top 10 dorsal points are: 35, 40, 36, 44, 34, 43, 39, 42, 38, 37.…”

Section: Radiationmentioning

confidence: 99%

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Phase Specific Pain Localization in Cluster Headache Patients.

Schröder¹,

Gaul²,

Drabik³

et al. 2020

Preprint

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“…The hypothesized mechanism of SPG modulation in migraine is the alteration of sensory processing in the TCC [72,73]. The modulation of SPG function, e.g.…”

Section: Spg Blockade (With Chemical Agents) In Migrainementioning

confidence: 99%

Therapeutic strategies that act on the peripheral nervous system in primary headache disorders

Tajti

Delia

Nyári

et al. 2019

Expert Review of Neurotherapeutics

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Introduction: Acute and preventive treatment of primary headache disorders is not completely resolved with regard to efficacy, safety, and tolerability. Hence, peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Areas covered: A PubMed search of papers published from January 2012 to October 2018 was conducted. The goal of this review was to analyze the efficacy and safety of invasive (implantable) peripheral neurostimulation methods (the occipital nerve, the cervical branch of vagal nerve, the sphenopalatine ganglion) and non-invasive (transcutaneous) peripheral neurostimulation methods (the occipital nerve, the supraorbital nerve, and the cervical and auricular branches of the vagal nerve), based on the results of published clinical trials and case series. Acting also on the peripheral nervous system, peripheral nerve (i.e. greater occipital nerve) and ganglion (i.e. sphenopalatine ganglion) blockades, botulinum neurotoxin type A-hemagglutinin complex therapies, and calcitonin generelated peptide-related monoclonal antibody treatments in this patient population are also discussed. Expert opinion: This review summarizes the latest results on the therapeutic strategies acting on the periphery in primary headache disorders. These therapeutic options are minimally invasive or noninvasive, efficacious, safe, and well tolerated. ARTICLE HISTORY

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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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Neurostimulation for the treatment of chronic migraine and cluster headache

Cited by 26 publications

References 79 publications

Phase Specific Pain Localization in Cluster Headache Patients.

Phase Specific Pain Localization in Cluster Headache Patients.

Therapeutic strategies that act on the peripheral nervous system in primary headache disorders

Management of Trigeminal Autonomic Cephalalgias Including Chronic Cluster

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