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Occipital Nerve Stimulation for Chronic Migraine

  • CHRONIC DAILY HEADACHE (S J WANG, SECTION EDITOR)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Occipital nerve stimulation may be effective in treating chronic migraine. Six studies, including three double-blind studies, were performed, with five showing evidence of benefit. However, of the three randomized, controlled trials, none has met a primary endpoint successfully. A separate study suggested a benefit for combined supraorbital and greater occipital nerve stimulation.

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References

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  1. Bigal ME, Serrano D, Reed M, et al. Chronic migraine in the population: burden, diagnosis, and satisfaction with treatment. Neurology. 2008;71:559–66.

    Article  PubMed  Google Scholar 

  2. Natoli JL, Manack A, Dean B, et al. Global prevalence of chronic migraine: a systematic review. Cephalalgia. 2010;30:599–609.

    CAS  PubMed  Google Scholar 

  3. Headache Classification Committee. The International Classification of Headache Disorders, 2nd Edition. Cephalalgia. 2004;24:1–160.

    Google Scholar 

  4. Bigal ME, Rapoport AM, Lipton RB, et al. Assessment of migraine disability using the Migraine Disabiilty Assessment (MIDAS) Questionnaire: a comparison of chronic migraine with episodic migraine. Headache. 2003;43:336–42.

    Article  PubMed  Google Scholar 

  5. Munakata J, Hazard E, Serrano D, et al. Economic burden of transformed migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2009;49:498–508.

    Article  PubMed  Google Scholar 

  6. Blumenfeld AM, Varon SF, Wilcox TK, et al. Disability, HRQoL and resource use among chronic and episodic migraineurs: results from the International Burden of Migraine Study (IBMS). Cephalalgia. 2011;31:301–15.

    Article  CAS  PubMed  Google Scholar 

  7. Meletiche DM, Lofland JH, Young WB. Quality of life differences between patients with episodic and transformed migraine. Headache. 2001;41:573–8.

    Article  CAS  PubMed  Google Scholar 

  8. Popeney CA, Alo KM. Peripheral neurostimulation for the treatment of chronic, disabling transformed migraine. Headache. 2003;43:369–75.

    Article  PubMed  Google Scholar 

  9. Oh MY, Ortega J, Bellotte JB, et al. Peripheral nerve stimulation for the treatment of occipital neuralgia and transformed migraine using a c1-2-3 subcutaneous paddle style electrode: a technical report. Neuromodulation. 2004;7:103–12.

    Article  PubMed  Google Scholar 

  10. Schwedt TJ, Dodick DW, Hentz J, et al. Occipital nerve stimulation for chronic headache–long-term safety and efficacy. Cephalalgia. 2007;27:153–7.

    Article  CAS  PubMed  Google Scholar 

  11. Reed KL, Black SB, Banta CJ, et al. Combined occipital and supraorbital neurostimulation for the treatment of chronic migraine headaches: initial experience. Cephalalgia. 2010;30:260–71. Study examines combined occipital and supraorbital nerve stimulation. Combined stimulation was substantially more effective than previous reports for ONS alone.

    CAS  PubMed  Google Scholar 

  12. Lipton RB, Goadsby PJ, Cady RK, et al. PRISM study: occipital nerve stimulation for treatment-refractory migraine. Cephalalgia. 2009;29:30-Abstract PO47. The third sham-controlled trial. Results were negative and only the abstract was reported

  13. Saper JR, Dodick DW, Silberstein SD, et al. Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study. Cephalalgia. 2011;31:271–85. Double-blind, sham-controlled trial to explore various endpoints. Occipital nerve block responders were excluded, but implanted.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Silberstein SD, Dodick D, Saper J, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: results from a randomized, multicenter, double-blind, controlled study. Cephalalgia. 2012;32:1165–79. Large, double-blind, controlled study. The primary endpoint of 50 % improvement in average VAS score proved negative. A 30 % improvement would have proved positive.

    Article  PubMed  Google Scholar 

  15. Diener HC, Schorn CF, Bingel U, et al. The importance of placebo in headache research. Cephalalgia. 2008;28:1003–11.

    Article  PubMed  Google Scholar 

  16. Serra G, Marchioretto F. Occipital nerve stimulation for chronic migraine: a randomized trial. Pain Physician. 2012;15:245–53.

    PubMed  Google Scholar 

  17. Anthony M. Headache and the greater occipital nerve. Clin Neurol Neurosurg. 1992;94:297–301.

    Article  CAS  PubMed  Google Scholar 

  18. Austad EA. Can proximity of the occipital artery to the greater occipital nerve act as a cause of idiopathic greater occipital nerualgia? An anatomical and histological evaluation of the artery-nerve relationship. Plastic Reconstructive Surg. 2007;119:2035–6.

    Article  CAS  Google Scholar 

  19. Weiner RL, Reed KL. Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation. 1999;2:217–21.

    Article  CAS  PubMed  Google Scholar 

  20. Matharu MS, Bartsch T, Ward N, et al. Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain. 2004;127:220–30.

    Article  PubMed  Google Scholar 

  21. Vadivelu S, Bolognese P, Milhorat TH, et al. Occipital nerve stimulation for refractory headache in the Chiari malformation population. Neurosurgery. 2012;70:1430–6.

    Article  PubMed  Google Scholar 

  22. Bartsch T, Goadsby PJ. Increased responses in trigeminocervical nociceptive neurons to cervical input after stimulation of the dura mater. Brain. 2003;126:1801–13.

    Article  CAS  PubMed  Google Scholar 

  23. Wall PD. The gate control theory of pain mechanisms. A re-examination and re-statement. Brain. 1978;101:1–18.

    Article  CAS  PubMed  Google Scholar 

  24. Oshinsky ML, Hirata H, Poletto C, et al. Dural sensitization is suppressed by occipital nerve stimulation. 701.07/RR2. Neuroscience Meeting Planner. Washington, DC: Society for Neuroscience; 2011.

    Google Scholar 

  25. Stiller CO, Linderoth B, O'Connor WT, et al. Repeated spinal cord stimulation decreases the extracellular level of gamma-aminobutyric acid in the periaqueductal gray matter of freely moving rats. Brain Res. 1995;699:231–41.

    Article  CAS  PubMed  Google Scholar 

  26. Lambru G, Matharu MS. Occipital nerve stimulation in primary headache syndromes. Ther Adv Neurol Disord. 2012;5:57–67. A well-written review of ONS in not just CM, but cluster headache, hemicrania continua, and Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT) and Short-lasting Unilateral Neuralgiform headache Attacks with cranial autonomic features (SUNA).

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Dr. William B. Young declares no potential conflicts of interest relevant to this article.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Jefferson Hospital for Neuroscience, Headache Center, Thomas Jefferson University, 900 Walnut Street, Second Floor, Suite #200, Philadelphia, PA, 19107, USA

    William B. Young

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  1. William B. Young
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Correspondence to William B. Young.

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This article is part of the Topical Collection on Chronic Daily Headache

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Young, W.B. Occipital Nerve Stimulation for Chronic Migraine. Curr Pain Headache Rep 18, 396 (2014). https://doi.org/10.1007/s11916-013-0396-x

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  • DOI: https://doi.org/10.1007/s11916-013-0396-x

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