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