nerivio Migraine device
A preliminary study of a new wireless Migraine patch that's worn on the arm suggests that it may be effective in reducing Migraine pain. The study utilized a new armband device that uses electrical stimulation to block the pain signals from reaching the brain. The patch uses rubber electrodes and a chip on an armband, which is controlled by a smartphone app.
"To evaluate the efficacy of remote nonpainful electrical upper arm skin stimulation in reducing migraine attack pain."1
- This was a prospective, double-blinded, randomized, crossover, sham-controlled trial.
- Study participants were randomized into two groups:
- one using the active device
- one using a sham device
- Participants were people who had episodic Migraine, both with and without aura and had two to eight Migraines per month without preventive medication for at least two months before the study began.
- Study participants applied skin electrodes to the upper arm soon after attack onset for 20 minutes, at various pulse widths.
- Study participants refrained from medications for two hours.
- Participants were asked to use the device for up to 20 attacks.
- Seventy-one participants completed the study and treated their Migraines with the device a total of 299 times.
- The endpoint (goal) was a 50 percent or greater reduction in pain.
- Greater pain reduction was found for active stimulation versus placebo.
- Fifty percent or greater pain reduction was obtained for 64 percent of participants using the active device based on best of 200-ms, 150-ms, and 100-ms pulse width stimuli per individual versus 26 percent for sham stimuli.
- For those who started with moderate to severe pain, their pain was reduced to mild or no pain in 58 percent of the participants at the highest level of stimulation, compared to 24 percent of participants using the sham stimulation. Thirty percent reported no pain after the highest level of stimulation, compared to six percent of those using the sham stimulation.
- Earlier application of the treatment, within 20 minutes of attack onset, yielded better results: 46.7 percent pain reduction as opposed to 24.9 percent reduction when started later.
"Nonpainful remote skin stimulation can significantly reduce migraine pain, especially when applied early in an attack. This is presumably by activating descending inhibition pathways via the conditioned pain modulation effect. This treatment may be proposed as an attractive nonpharmacologic, easy to use, adverse event free, and inexpensive tool to reduce migraine pain."1
Study author comments:
David Yarnitsky, MD, of Technion Faculty of Medicine in Haifa, Israel, and a member of the Medical Advisory Board for Theranica, make of the stimulation device, commented:
"These results need to be confirmed with additional studies, but they are exciting. People with Migraine are looking for non-drug treatments, and this new device is easy to use, has no side effects, and can be conveniently used in work or social settings... These results are similar to those seen for the triptan medications for Migraine."2
Comments and implications for patients:
This device may well be an effective future treatment for episodic Migraine. This was a very small study that needs to be replicated, and full clinical trials must be conducted. Thus, as encouraging as this first study looks, the device is still several years from being available, and its progressing to being approved and marketed depends on additional trials.While this study does give us hope of an new and effective treatment for episodic Migraine, we'll need to hold that hope for a few years before we see this device among our tools for Migraine relief.
More helpful articles on devices for Migraine:
Cefaly Device Approved by the FDA for Migraine Treatment
Update on Spring TMS for Migraine - Goodbye Botox
1 Yarinstky D, Volohk l, Ironi A, et al. Nonpainful remote electrical stimulation alleviates episodic migraine pain. Neurology 2017;88:1–6.
2 American Academy of Neurology. Study: Wireless stimulation may ease migraine pain as well as drugs. American Academy of Neurology. Minneapolis. March 1, 2017.