Premium
An Update on Non‐Pharmacological Neuromodulation for the Acute and Preventive Treatment of Migraine
Author(s) -
Puledda Francesca,
Goadsby Peter J.
Publication year - 2017
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.13069
Subject(s) - neuromodulation , medicine , migraine , context (archaeology) , transcranial direct current stimulation , blinding , aura , transcranial magnetic stimulation , stimulation , occipital nerve stimulation , brain stimulation , anesthesia , vagus nerve stimulation , intensive care medicine , randomized controlled trial , surgery , vagus nerve , alternative medicine , paleontology , pathology , biology
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.