research
Helping You Live Better
Portable Neurostimulation on the Horizon?
By Jackie Walker Gibson
Bioelectric fish were once used to treat headache.
IN 46 AD, Scribonis Largus( court physician to the Roman emperor Claudius) wrote that he could“ permanently cure” a headache through the use of bioelectric fish placed on the area of pain. Today, electricity is used to reduce head pain through a procedure called neurostimulation. That procedure typically involves surgery in a physician’ s office. But a new trial could turn neurostimulation into an affordable, at-home treatment for migraine relief.
HEADACHE AND PAIN SIGNALS
Neurostimulation for headache involves sending electrical impulses through the nerves to affect the signals those nerves send to the brain. The thinking behind the procedure is that if you can stop the nerves from sending pain signals or if you can change the way the brain processes those signals, then you can stop the feeling of pain. Since its introduction to the headache world in 1977, neurostimulation has been used to reduce the pain associated with cluster headache, migraine and other headache conditions.
Neurostimulation comes in many forms, depending on the area of the body that is stimulated. For example:
• Percutaneous electrical nerve stimulation involves insertion of needle probes into the skin.
• Transcranial holocephalic stimulation involves the use of electrodes placed about the skull.
• Peripheral nerve stimulation involves the application of electrical impulses to branches of afferent nerves, which conduct sensory neurons.
• Vagal nerve stimulation involves wrapping an electrode around the vagus nerve in the neck.
• Occipital nerve stimulation involves the application of electrical impulses over the occipital nerves, located in the spine in the upper neck.
• Deep brain stimulation involves placement of electrodes through the skull, into structures in the brain. 1, 2 Because neurostimulation usually involves surgery— and because surgery always carries risks— headache specialists generally advise that individuals with headache only use neurostimulation as a last resort.
A PORTABLE BREAKTHROUGH?
A new clinical trial, which began in Summer 2012 at the University of Kent, seeks to change the need for invasive surgery as part of neurostimulation. The researchers hope to discover a type of neurostimulation device for migraine that would be portable and cheaply manufactured. 3
“ Over the last 30 years, numerous acute and preventive therapies for headache and migraine have evolved,” says Seymour Diamond, MD, executive chairman of the National Headache Foundation and founder and director emeritus of the Diamond Headache Clinic.“ It should be noted that there is a subset of patients who are resistant or not helped by these‘ welcome’ innovations. Personally, I applaud and am hopeful that newer treatments, such as portable neurostimulators, will provide relief to these recidivist patients.” HW
1. Jenkins et al.“ Neurostimulation for Primary Headache Sisorders, Part 1: Pathophysiology and natomy, History of Neuromodulation in Headache Treatment, and Review of Peripheral Neuromodulation in Primary Headaches.” Headache. 2011; 51:1254-1266.
2. Jenkins et al.“ Neurostimulation for Primary Headache Disorders, Part 2: Review of Central Neurostimulators for Primary Headache, Overall Therapeutic Efficacy, Safety, Cost, Patient Selection, and Future Research in Headache Neuromodulation.” Headache. 2011; 51:1408-1418.
3. ScientistLive.“ US-Kent Research Aims to Find a New Treatment for Migraine.” www. scientistlive. com / European-Science-News / Drug _ Discovery / US-Kent _ research _ aims _ to _ find _ a _ new _ treatment _ for _ migraine / 25640 /
10 HEAD WISE | Volume 2, Issue 4 • 2012