The effect of transcutaneous Vagus Nerve Stimulation in migraine: an alternative treatment of chronic migraine

Abstract

Context: Migraine is a disabling condition that is currently underdiagnosed and undertreated. Transcutaneous vagus nerve stimulation (VNS) is among the most researched non-invasive brain stimulation techniques for migraine control. Objectives: In this integrative review, we discuss the effects of VNS parameters (waveform, frequency, intensity, cycle, and current), central, and clinical mechanisms in auricular (taVNS) or cervical (tcVNS) transcutaneous VNS in the control of migraine pain.Methods: PubMed (National Library of Medicine), Cochrane Library, CAPES Journals (Portal of Journals of the Coordination for the Improvement of Higher Education Personnel), Virtual Health Library (VHL), and Google Scholar were searched by computer from the establishment of within the 10-year period (2011–2021). Results: Initially, a total of 10,017 articles were identified. After applying the exclusion criteria, 10,007 articles were excluded. The eligibility criteria were analyzed and only ten articles fulfilled the criteria. The most used parameters in this study for VNS were the frequencies of 1 Hz, 25 Hz, and 30 Hz. The 1 Hz stimulation caused a more significant reduction in the number of days with headache. The total stimulation time varies between studies, ranging from 2 min to 240 min, and can be repeated for a period or a single session. Studies that used a longer treatment period showed clinical results in reducing pain and analyzed the scores. Moreover, studies have shown reduced intensity or severity of pain after taVNS.Conclusions: The studies performed taVNS or tcVNS, and both methods had positive effects on migraine control, pain reduction, and migraine score.

Dorsal Lytic Lesions: Cancer or Infection?

“…However, back pain is a symptom that can present in various clinical conditions. Infectious spondylodiscitis is estimated to affect approximately one in 100,000 to one in 250,000 individuals, rendering it still a relatively uncommon clinical condition [1]. This condition exhibits a bimodal distribution, typically impacting patients who are either under 20 years of age or in the age range of 50-70 years [1].…”

“…Infectious spondylodiscitis is estimated to affect approximately one in 100,000 to one in 250,000 individuals, rendering it still a relatively uncommon clinical condition [1]. This condition exhibits a bimodal distribution, typically impacting patients who are either under 20 years of age or in the age range of 50-70 years [1]. It corresponds to inflammation of the vertebral bodies and intervertebral disc and typically presents an insidious progression.…”

“…The microbial composition depends on the host's risk factors and the specific epidemiological factors in the local area [5]. The most frequently isolated microbiological agents nowadays are Staphylococcus aureus, Enterobacteriaceae, commonly Escherichia coli, Mycobacterium tuberculosis, and Brucella spp [1,2]. While hematogenous dissemination remains the primary source of infection, blood cultures often yield negative results [6].…”

“…Spondylodiscitis, an infrequent condition, often leads to prolonged hospital stays necessary for its management [1,2]. It involves inflammation within the vertebral bodies and intervertebral discs, typically displaying a slow and subtle progression [1,2].…”

“…Spondylodiscitis, an infrequent condition, often leads to prolonged hospital stays necessary for its management [1,2]. It involves inflammation within the vertebral bodies and intervertebral discs, typically displaying a slow and subtle progression [1,2]. Despite its rarity, the number of cases has been increasing in the past years [3], highlighting the importance of considering this condition.…”