Neurostimulators for the Treatment of Primary Headaches

Massimo Leone; Alberto Proietti Cecchini; Angelo Franzini; Gennaro Bussone


Future Neurology. 2013;8(4):457-467. 

In This Article

Other Types of Nerve Stimulation

Stimulation of the vagal nerve has been used to treat epilepsy, depression and other conditions. Efficacy data on vagal nerve stimulation in headache are mainly from retrospective studies. In one study, three of four migraine patients experienced a substantial reduction in headache frequency.[82] Another study reported that headache frequency in eight of ten migraine patients reduced by 50% or more in the 6 months following initiation of treatment.[83] Improved headache frequency was also reported in two epileptic patients.[84]

A 'good response' to vagus nerve stimulation was found in two of four patients with chronic migraine and in two patients with chronic cluster headache.[85] In a subsequent study, two of four patients with refractory chronic migraine reported significant improvement with vagus nerve stimulation.[86] Vagus nerve stimulation modulates several cortical and subcortical structures involved in nociception, and its antinociceptive action is well-documented.[87] Vagus nerve stimulation can also be performed transcutaneously in the neck or outer ear and it might be worthwhile testing these techniques in headache.