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Neurostimulation for primary headache disorders

  • Todd J. SchwedtEmail author
Article

Abstract

Neurostimulation has emerged as a potential treatment option for patients with chronic, disabling, intractable primary headache disorders. Although safety and efficacy data are limited in quantity, there is accumulating experience with the use of peripheral nerve stimulation for the treatment of intractable occipital neuralgia, cluster headache, migraine, and less common headache disorders. Deep brain stimulation has been used to treat intractable chronic cluster headache and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing. This article discusses the theorized mechanisms of action of these novel treatment modalities and summarizes current knowledge regarding safety and efficacy of neurostimulation for the treatment of headache.

Keywords

Deep Brain Stimulation Cluster Headache Chronic Migraine Peripheral Nerve Stimulation Posterior Hypothalamus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References and Recommended Reading

  1. 1.
    Chronic Daily Headache for Clinicians. Edited by Goadsby PJ, Silberstein SD, Dodick DW. Hamilton, ON: BC Decker; 2005.Google Scholar
  2. 2.
    Melzack R, Wall PD: Pain mechanisms: a new theory. Science 1965, 150:971–979.PubMedCrossRefGoogle Scholar
  3. 3.
    Ignelzi RJ, Nyquist JK: Direct effect of electrical stimulation on peripheral nerve evoked activity: implications in pain relief. J Neurosurg 1976, 45:159–165.PubMedCrossRefGoogle Scholar
  4. 4.
    Kaube H, Keay K, Hoskin KL, et al.: Expression of c-fos-like immunoreactivity in the trigeminal nucleus caudalis and high cervical cord following stimulation of the sagittal sinus in the cat. Brain Res 1993, 629:95–102.PubMedCrossRefGoogle Scholar
  5. 5.
    Hoski KL, Kaube H, Goadsby PJ: Sumatriptan can inhibit trigeminal afferents by an exclusively neural mechanism. Brain 1996, 119:1419–1428.CrossRefGoogle Scholar
  6. 6.
    Goadsby PJ, Knight YE, Hoskin KL: Stimulation of the greater occipital nerve increases metabolic activity in the trigeminal nucleus caudalis and cervical dorsal horn of the cat. Pain 1997, 73:23–28.PubMedCrossRefGoogle Scholar
  7. 7.
    Matharu MS, Bartsch T, Ward N, et al.: Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain 2004, 127:220–230.PubMedCrossRefGoogle Scholar
  8. 8.
    Jasper J, Hayek S: Implanted occipital nerve stimulators. Pain Physician 2008, 11:187–200.PubMedGoogle Scholar
  9. 9.
    Schwedt TJ, Dodick DW, Trentman TL, Zimmerman RS: Response to occipital nerve block is not useful in predicting efficacy of occipital nerve stimulation. Cephalalgia 2007, 27:271–274.PubMedCrossRefGoogle Scholar
  10. 10.
    Weiner R, Reed KL: Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation 1999, 2:217–221.CrossRefGoogle Scholar
  11. 11.
    Melvin EA, Jordan FR, Weiner RL, Primm D: Using peripheral stimulation to reduce the pain of C2-mediated occipital headaches: a preliminary report. Pain Physician 2007, 10:453–460.PubMedGoogle Scholar
  12. 12.
    Slavin KV, Nersesyan H, Wess C: Peripheral neurostimulation for treatment of intractable occipital neuralgia. Neurosurgery 2006, 58:112–119.PubMedCrossRefGoogle Scholar
  13. 13.
    Kapural L, Mekhail N, Hayek SM, et al.: Occipital nerve electrical stimulation via the midline approach and subcutaneous surgical leads for the treatment of severe occipital neuralgia: a pilot study. Anesth Analg 2005, 101:171–174.PubMedCrossRefGoogle Scholar
  14. 14.
    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, 7:103–112.CrossRefGoogle Scholar
  15. 15.
    Johnstone CSH, Sundaraj R: Occipital nerve stimulation for the treatment of occipital neuralgia—eight case studies. Neuromodulation 2006, 9:41–47.CrossRefGoogle Scholar
  16. 16.
    Burns B, Watkins L, Goadsby PJ: Treatment of medically intractable cluster headache by occipital nerve stimulation: long-term follow-up of eight patients. Lancet 2007, 369:1099–1106.PubMedCrossRefGoogle Scholar
  17. 17.
    Magis D, Allena M, Bolla M, et al.: Occipital nerve stimulation for drug-resistant chronic cluster headache: a prospective pilot study. Lancet Neurol 2007, 6:314–321.PubMedCrossRefGoogle Scholar
  18. 18.
    Lainez MJA, Piera A, Salvador A, et al.: Efficacy and safety of occipital nerve stimulation for treatment of chronic cluster headache. Headache 2008, 48(Suppl 1):S15.Google Scholar
  19. 19.
    Schwedt TJ, Dodick DW, Hentz J, et al.: Occipital nerve stimulation for chronic headache-long-term safety and efficacy. Cephalalgia 2007, 27:153–157.PubMedCrossRefGoogle Scholar
  20. 20.
    Vargas BB, Dodick DW, Trentman TL, et al.: Occipital nerve stimulation via the BION device for the treatment of medically refractory chronic cluster headache [abstract]. Headache 2008, 48(Suppl 1):S52.Google Scholar
  21. 21.
    Popeney CA, Alo KM: Peripheral neurostimulation for the treatment of chronic, disabling transformed migraine. Headache 2003, 43:369–375.PubMedCrossRefGoogle Scholar
  22. 22.
    Saper J, Goadsby PJ, Silberstein S, et al.: Occipital nerve stimulation (ONS) for treatment of intractable migraine headache: 3-month results from the ONSTIM feasibility study [abstract LB-OR27]. Presented at the 50th Anniversary Scientific Meeting of the American Headache Society. Boston; June 26–29, 2008.Google Scholar
  23. 23.
    Goadsby PJ: Neurostimulation in primary headache syndromes. Expert Rev Neurother 2007, 7:1785–1789.PubMedCrossRefGoogle Scholar
  24. 24.
    Amin S, Buvanendran A, Park K-S, et al.: Peripheral nerve stimulator for the treatment of supraorbital neuralgia: a retrospective case series. Cephalalgia 2008, 28:355–359.PubMedCrossRefGoogle Scholar
  25. 25.
    Asensio-Samper JM, Villanueva VL, Perez AV, et al.: Peripheral neurostimulation in supraorbital neuralgia refractory to conventional therapy. Pain Pract 2008, 8:120–124.PubMedCrossRefGoogle Scholar
  26. 26.
    Narouze SN, Kapural L: Supraorbital nerve electric stimulation for the treatment of intractable chronic cluster headache: a case report. Headache 2007, 47:1100–1102.PubMedCrossRefGoogle Scholar
  27. 27.
    Slavin KV, Colpan ME, Munawar N, et al.: Trigeminal and occipital peripheral nerve stimulation for craniofacial pain: a single-institution experience and review of the literature. Neurosurg Focus 2006, 21:E5.CrossRefGoogle Scholar
  28. 28.
    Leone M, Franzini A, Broggi G, et al.: Deep brain stimulation for intractable chronic cluster headache: proposals for patient selection. Cephalalgia 2004, 24:934–937.PubMedCrossRefGoogle Scholar
  29. 29.
    May A, Bahra A, Buchel C, et al.: Hypothalamic activation in cluster headache attacks. Lancet 1998, 352:275–278.PubMedCrossRefGoogle Scholar
  30. 30.
    Sprenger T, Boecker H, Tolle TR, et al.: Specific hypothalamic activation during a spontaneous cluster headache attack. Neurology 2004, 62:516–517.PubMedGoogle Scholar
  31. 31.
    May A, Ashburner J, Buchel C, et al.: Correlation between structural and functional changes in brain in an idiopathic headache syndrome. Nat Med 1999, 5:836–838.PubMedCrossRefGoogle Scholar
  32. 32.
    May A, Bahra A, Buchel C, et al.: Functional MRI in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol 1999, 46:791–793.PubMedCrossRefGoogle Scholar
  33. 33.
    Matharu MS, Cohen AS, Frackowiak RS, Goadsby PJ: Posterior hypothalamic activation in paroxysmal hemicrania. Ann Neurol 2006, 59:535–545.PubMedCrossRefGoogle Scholar
  34. 34.
    Matharu MS, Cohen AS, McGonigle DJ, et al.: Posterior hypothalamic and brainstem activation in hemicrania continua. Headache 2004, 44:747–761.PubMedCrossRefGoogle Scholar
  35. 35.
    May A, Leone M, Boecker H, et al.: Hypothalamic deep brain stimulation in positron emission tomography. J Neurosci 2006, 26:3589–3593.PubMedCrossRefGoogle Scholar
  36. 36.
    May A: Hypothalamic deep-brain stimulation: target and potential mechanism for the treatment of cluster headache. Cephalalgia 2008, 28:799–803.PubMedCrossRefGoogle Scholar
  37. 37.
    Schoenen J, Di Clemente L, Vandenheede M, et al.: Hypothalamic stimulation in chronic cluster headache: a pilot study of efficacy and mode of action. Brain 2005, 128:940–947.PubMedCrossRefGoogle Scholar
  38. 38.
    Leone M, Proietti Cecchini A, Franzini A, et al.: Lessons from 8 years’ experience of hypothalamic stimulation in cluster headache. Cephalalgia 2008, 28:789–797.Google Scholar
  39. 39.
    Leone M, Franzini A, Broggi G, Bussone G: Hypothalamic stimulation for intractable cluster headache: long-term experience. Neurology 2006, 67:150–152.PubMedCrossRefGoogle Scholar
  40. 40.
    Bartsch T, Pinsker MO, Rasche D, et al.: Hypothalamic deep brain stimulation for cluster headache: experience from a new multicase series. Cephalalgia 2008, 28:285–295.PubMedCrossRefGoogle Scholar
  41. 41.
    Starr PA, Barbaro NM, Raskin NH, Ostream JL: Chronic stimulation of the posterior hypothalamic region for cluster headache: technique and 1-year results in four patients. J Neurosurg 2007, 106:999–1005.PubMedCrossRefGoogle Scholar
  42. 42.
    Owen SLF, Green AL, Davies P, et al.: Connectivity of an effective hypothalamic surgical target for cluster headache. J Clin Neurosci 2007, 14:955–960.PubMedCrossRefGoogle Scholar
  43. 43.
    D’Andrea G, Nordera GP, Piacentino M: Effectiveness of hypothalamic stimulation in two patients affected by intractable chronic cluster headache [abstract]. Neurology 2006, 66(Suppl 2):A140.Google Scholar
  44. 44.
    Benabid AL, Chabardes S, Seigneuret E, Torres N: Intraventricular stimulation for targets close to the midline: periaqueductal gray, posterior hypothalamus, anterior hypothalamus, subcommissural structures [abstract]. Acta Neurochir (Wien) 2006, 148:I–LXIV.Google Scholar
  45. 45.
    Mateos V, Seijo F, Lozano B, et al.: Deep brain stimulation for refractory chronic cluster headache. First national cases [in Spanish] [abstract]. Neurologia 2007, 22:96.Google Scholar
  46. 46.
    Leone M, Franzini A, D’Andrea G, et al.: Deep brain stimulation to relieve drug-resistant SUNCT. Ann Neurol 2005, 57:924–927.PubMedCrossRefGoogle Scholar
  47. 47.
    National Institutes of Health: ClinicalTrials.gov. Available at http://www.clinicaltrials.gov (NCT00662935; NCT00205894). Accessed January 27, 2008.

Copyright information

© Current Medicine Group, LLC 2009

Authors and Affiliations

  1. 1.Washington University School of MedicineSt. LouisUSA

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