Skip to main content

Advertisement

SpringerLink
Log in

Peripheral neuromodulation in chronic migraine

  • SYMPOSIUM: PERIPHERAL NEUROMODULATION IN CHRONIC MIGRAINE
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Patients with chronic migraines are often refractory to medical treatment. Therefore, they might need other strategies to modulate their pain, according to their level of disability. Neuromodulation can be achieved with several tools: meditation, biofeedback, physical therapy, drugs and electric neurostimulation (ENS). ENS can be applied to the central nervous system (brain and spinal cord), either invasively (cortical or deep brain) or non-invasively [cranial electrotherapy stimulation, transcranial direct current stimulation and transcranial magnetic stimulation]. Among chronic primary headaches, cluster headaches are most often treated either through deep brain stimulation or occipital nerve stimulation because there is a high level of disability related to this condition. ENS, employed through several modalities such as transcutaneous electrical nerve stimulation, interferential currents and pulsed radiofrequency, has been applied to the peripheral nervous system at several sites. We briefly review the indications for the use of peripheral ENS at the site of the occipital nerves for the treatment of chronic migraine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. D’Amico D, Grazzi L, Usai S, Raggi A, Leonardi M, Bussone G (2011) Disability in chronic daily headache: state of the art and future directions. Neurol Sci 32 Suppl 1:S71–6

    Google Scholar 

  2. Lipton RB (2011) Chronic migraine, classification, differential diagnosis, and epidemiology. Headache 51(Suppl 2):77–83

    Article  PubMed  Google Scholar 

  3. Manzoni GC, Bonavita V, Bussone G, Cortelli P, Narbone MC, Cevoli S, D’Amico D, De Simone R, Torelli P, On behalf of ANIRCEF (Associazione Neurologica Italiana Ricerca Cefalee) (2011) Chronic migraine classification: current knowledge and future perspectives. J Headache Pain 12:585–592

    Article  PubMed  Google Scholar 

  4. Goadsby PJ, Schoenen J, Ferrari M et al (2006) Towards a definition of refractory headache for use in clinical practice and trials. Cephalalgia 26:1168–1170

    Article  PubMed  CAS  Google Scholar 

  5. Schulman EA, Lake AE, Goadsby PJ et al (2008) Defining refractory migraine and refractory chronic migraine: proposed criteria from the refractory headache special interest section of the American Headache Society. Headache. 48:778–782

    Article  PubMed  Google Scholar 

  6. Schulman EA, Peterlin BL, Lake AE, Lipton RB, Hanlon A, Siegel S, Levin M, Goadsby PJ, Markley HG (2009) Defining refractory migraine: results of the RHSIS Survey of American Headache Society members. Headache 49:509–518

    Article  PubMed  Google Scholar 

  7. Irimia P, Palma JA, Fernandez-Torron R, Martinez-Vila E (2011) Refractory migraine in a headache clinic population. BMC Neurol 11:94

    Google Scholar 

  8. Silberstein SD, Dodick DW, Pearlman S (2010) Defining the pharmacologically intractable headache for clinical trials and clinical practice. Headache 50:1499–1506

    Article  PubMed  Google Scholar 

  9. Pattle RE, Weddell G (1948) Observations on electrical stimulation of pain fibres in an exposed human sensory nerve. J Neurophysiol 11(2):93–98

    PubMed  CAS  Google Scholar 

  10. Jenkins B, Tepper SJ (2011) Neurostimulation for primary headache disorders, part 1: pathophysiology and anatomy, history of neuromodulation in headache treatment, and review of peripheral neuromodulation in primary headaches. Headache 51(8):1254–1266 Review

    Article  PubMed  Google Scholar 

  11. Saper JR, Dodick DW, Silberstein SD, McCarville S, Sun M, Goadsby PJ, ONSTIM Investigators (2011) Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study. Cephalalgia 31(3):271–285

    Article  PubMed  Google Scholar 

  12. Popeney C, Alo K (2003) Peripheral neurostimulation for the treatment of chronic, disabling transformed migraine. Headache 43:369–375

    Article  PubMed  Google Scholar 

  13. Schwedt TJ, Dodick DW, Hentz J, Trentman TL, Zimmerman RS (2007) Occipital nerve stimulation for chronic headache—long-term safety and efficacy. Cephalalgia 27:153–157

    Google Scholar 

  14. Trentman TL, Rosenfeld DM, Vargas BB, Schwedt TJ, Zimmerman RS, Dodick DW (2009) Greater occipital nerve stimulation via the Bion microstimulator: implantation technique and stimulation parameters. Clinical trial: NCT00205894. Pain Physician 12(3):621–628

    PubMed  Google Scholar 

  15. Silberstein S, Dodick D, Saper J, Huh B et al (2011) The safety and efficacy of peripheral nerve stimulation of the occipital nerve for the management of chronic migraine. Poster presented at: 15th Congress of the International Headache Society, Berlin, 23–26 June 2011

  16. D’Amico D, Leone M, Grazzi L, Bussone G (2008) When should “chronic migraine” patients be considered “refractory” to pharmacological to pharmacological prophylaxis? Neurol Sci 29:S55–S58

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors certify that there is no actual or potential conflict of interest in relation to this article.

Author information

Authors and Affiliations

  1. Headache Center, St. Bortolo Hospital, Vicenza, Italy

    F. Perini & A. De Boni

Authors
  1. F. Perini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. De Boni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Perini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Perini, F., De Boni, A. Peripheral neuromodulation in chronic migraine. Neurol Sci 33 (Suppl 1), 29–31 (2012). https://doi.org/10.1007/s10072-012-1039-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-012-1039-4

Keywords

Search

Navigation