Chronic Migraine (CM) is defined as having Migraine and/or tension-type headache (TTH) 15 or more days a month (eight days of which must be Migraine), lasting at least three months. CM is debilitating not only for the patient but the patient's family and friends are negatively affected too. Unfortunately, there are very few treatment options for CM and those that are available are often ineffective.
Drs. Silberstein, Dodick, Saper, Huh, Reed, Narouze and Mekhail conducted a study that was presented this past June at the 54th Annual American Headache Society Scientific Meeting. They hoped to show peripheral nerve stimulation (PNS) near the occipital nerves is beneficial for those with CM. Participants in the study, "Efficacy of Occipital Nerve Stimulation for the Management of Intractable Chronic Migraine: Results from a Prospective, Multicenter, Double-Blinded, Controlled Study" must have unsuccessfully tried at least three Migraine preventive medications, have 15 or more days of headache pain lasting at least four hours and the headaches had to be considerably debilitating. Participants were screened using a validated disability instrument like the MIDAS (Migraine Disability Assessment), Zung Pain and Distress Scale (PAD) and HIT-6 (Headache Impact Test).
Of the 125 participants, 122 completed the 12 week trial. All participants had a neurostimulation system installed and were then broken down into two groups: an active group (the system was on) and a control group (the system was not turned on). To determine how the subjects were feeling during the trial, researchers used the MIDAS scale, the Zung PAD, the patient's quality of life and how satisfied the patients were with the system. The goal was to have a 50% reduction in painful days, though the goal was not met. However, a 30% reduction was found in the active group compared to the control group, which is a significant improvement. Researchers also found:
- The number of headache days in the active group compared to the control group dropped by 7.0 and 2.7, respectively.
- Total MIDAS scores improved by 72.9 in the active group and 27.2 in the control group.
- Using PAD scores, the active group increased their score to 14.6 and the control group to 5.5.
- 36.4% of active participants saw a reduction in pain days, while only 13.5% of the control group saw improvement.
- An impressive 64.8% of participants in the active group felt their quality of life improved while only 18.9% of the control group felt the same way.
- 46.6% of active participants were satisfied with the study while 16.2% of the control group felt satisfied.
Researchers feel this study warrants PNS as a viable alternative for further investigation. Let's hope this small study continues to build on a new treatment option for those with chronic Migraine.
Silberstein, S.; Dodick, D.; Saper, J.; Huh, B.; Reed, K.; Narouze, S.; Meka, N. "Efficacy of Occipital Nerve Stimulation for the Management of Intractable Chronic Migraine: Results from a Prospective, Multicenter, Double-Blinded, Controlled Study." Scientific Paper Presentation. 54th Annual Scientific Meeting of the American Headache Society. Los Angeles. June, 2012.