Credit: Thinkstock Back in June, I shared the great information that the Spring TMS device (STMS) had finally been approved by the FDA for the acute treatment of migraine with aura. The STMS is used to deliver a short magnetic pulse to the back of the skull. The pulse travels through the skull and into brain tissue. The magnetic field induces very mild electrical currents in the brain tissue to excite and depolarize neurons in the brain. This process is thought to interrupt the abnormal electrical activity associated with migraine and cortical spreading depression (CSD). Since it’s CSD that occurs when we encounter a migraine trigger and starts the migrainous process in the brain, interrupting it can abort a migraine attack.
Clinical trials are now underway to see if the Spring TMS device can work for migraine prevention when used twice a day to help prevent cortical spreading depression. These trials are being conducted at six migraine and headache clinics in the United States, the same six that, until recently, were the only places where the device could be prescribed. The study leaders and their centers are:
- Dr. Sheena Aurora at the Stanford Headache Center in Palo Alto, California;
- Dr. Andrew Charles at the UCLA Headache Center in Los Angeles, California;
- Dr. David Dodick at the Mayo Clinic Scottsdale Headache Center in Scottsdale, Arizona;
- Dr. Peter Goadsby at the UCSF Headache Center in San Francisco, California;
- Dr. Richard Lipton at the Montefiore Headache Center in New York; and
- Dr. Stephen Silberstein at the Jefferson Headache Center in Philadelphia, Pennsylvania.
Since I first wrote about the approval of the Spring and the six centers at which it was available, many people have asked me when it would be more widely available. I have good news for everyone who has been waiting. By October, the Spring will be available at 30 academic headache and migraine centers. (Academic centers are centers located in colleges and universities.) If you’re interested in the STMS, and your doctor is at an academic center, ask your doctor about it. You can also email eNeura (the company that makes the device), and they’ll tell you if your doctor is currently prescribing the device.
Since this technology is so new, eNeura has set up additional services to assist migraine patients:
- They have a team of highly trained nurses serving as clinical educators who are available by phone if patients have any questions regarding the use of the Spring TMS.
- eNeura has retained an insurance reimbursement consulting service for patients wishing to pursue insurance coverage. They will help patients and doctors.
This is another question people have been asking, and it’s an excellent question. The reality is that the device is very complex and sophisticated, and the potential market is much smaller than the potential market for other devices and medications. Thus, the price, if the device were to be purchased, would be prohibitive. So, here’s how it works:
- Your doctor sends a three-month prescription for the Spring TMS to eNeura.
- eNeura prepares your device and ships it to your home.
- You are billed $250 per month for the use of the device, three months at a time.
- When the device is first prepared and shipped, there is a one-time charge of $50.00.
- Total charges for the first three-month period come to $800.00.
- Near the end of the three-month period, your doctor can renew the prescription. eNeura then mails a small data card to replace the original data card in the machine.
- If the prescription is not renewed and the new data card inserted in the Spring TMS unit, it stops working.
- eNeura instructs everyone to keep the original packaging. If a patient stops using the device, it needs to be shipped back to eNeura.
Wrapping It Up:
- The Spring TMS device is approved by the FDA for the acute treatment of migraine with aura - treating migraine attacks when they occur. It is also in clinical trials for migraine prevention.
- Although there have not been clinical trials of the Spring TMS for the acute treatment of migraine without aura, there is anecdotal evidence of its effectiveness for migraine without aura.
- By October, the Spring TMS device will be available in 30 academic migraine and headache centers in the U.S.
- The cost of using the device is $250 per month.
- As with any new modality of treatment, there is not as yet a track record with insurance companies, but eNeura has contracted with a company to assist patients with insurance claims for reimbursement.
- Although the FDA approval is for the acute treatment of migraine with aura only, doctors can prescribe it off-label to let patients try it for the acute treatment of migraine without aura and for migraine prevention.
My Personal Spring Experience.:
I’ve been using the Spring TMS device for my migraines since July. I’ll be writing about my experience soon and on a regular basis after that to let you know how it’s working for me.
Reviewed by David Watson, MD.
© Teri Robert, 2015. • Last updated August 27, 2015.