Are you one of many 20 million to 40 million individuals within the US struggling with migraine complications? In that case, right here’s information price noting: The FDA has simply authorized an over-the-counter nerve stimulation gadget that delivers delicate electrical shocks to the brow as a method to forestall or deal with migraine complications.

This may appear to be an unlikely method to deal with migraines, so how did we get right here? And what’s the proof that it really works? Is that this a recreation changer? Hype? Or a remedy that falls someplace in between?

Our altering understanding of what causes migraines

Blood vessels all through the physique, together with these close to the mind, slender (constrict) and open up (dilate) recurrently, all through the day. That’s regular, and it varies relying on the state of affairs. Sleep, physique temperature, bodily exercise, and lots of different elements have an effect on this exercise of blood vessels. Not way back, standard knowledge held that migraines had been because of an exaggeration of this regular constriction and dilation of blood vessels. Consultants thought {that a} set off — like sure meals, stress, or a number of different elements — made blood vessels supplying pain-sensitive components of the mind all of the sudden constrict for a short time after which dilate, earlier than returning to regular. We all know that comparable blood vessel modifications happen in different situations resembling Raynaud’s disease, so this was an interesting concept to clarify migraine signs.

If migraines had been because of exaggerated blood vessel constriction and dilation in some individuals, that might clarify why migraines are so widespread, momentary, and never related to any everlasting harm to the mind or different components of the physique. Nevertheless, this concept is now thought of fallacious.

The present concept of migraine

Present proof (as described in this review) means that migraine complications start with an irregular activation of cells within the nervous system that spreads throughout the mind. This results in irritation close to pain-sensitive components of the mind, the discharge of chemical messengers, and modifications within the sensitivity of nerves that carry ache alerts. Among the many nerves concerned are branches of the trigeminal nerve. This nerve gives sensation to areas of the face, and controls muscle tissues that permit us to chunk or chew. It’s additionally linked to the pain-sensitive lining of the mind.

This evolving understanding of potential causes of migraine complications has led to remedies that focus much less on blood vessel modifications and extra on methods to dam chemical messengers concerned in ache alerts. Triptan medicines, together with sumatriptan (Imitrex and others) and rizatriptan (Maxalt), are good examples.

What about nerve stimulation for migraines?

Lately, research have demonstrated {that electrical} stimulation of branches of the trigeminal nerve over the brow can deal with migraine complications and even forestall them. One such gadget, the Cefaly Dual, has been out there by prescription to stop migraine complications since 2014. It was simply cleared as an over-the-counter gadget to stop and deal with migraine complications. Clearance differs from FDA approval for effectiveness and security for medicine and lifesaving expertise like defibrillators; it permits medical gadget makers to market a product as a result of the FDA considers it secure and much like different legally marketed merchandise.

The proof supporting nerve stimulation to stop or deal with migraine contains the next:

  • A study published in 2013 enrolled 67 individuals with migraines and in contrast electrical stimulation to sham stimulation for 20 minutes every day as a method to forestall complications. Over three months, fewer complications and a diminished want for migraine medicine had been noticed amongst these getting the actual remedy. Enchancment by no less than 50% was famous in 38% of research topics, however in solely 12% of the sham group.
  • In a 2013 survey of greater than 2,300 individuals utilizing electrical stimulation for 20 minutes every day for 2 months to stop migraine, simply over half reported satisfaction with the gadget and a willingness to purchase it.
  • A 2019 study randomly assigned 106 individuals with an lively migraine headache to obtain electrical stimulation over the brow or a sham remedy (minimal electrical stimulation) for one hour. These receiving remedy reported ache discount of practically 60% whereas these within the sham group had solely 30% ache discount.

What about downsides?

None of those research reported critical unintended effects associated to electrical stimulation. Whereas a tingling sensation on the web site of stimulation was widespread, few perceived it as painful or bothersome sufficient to cease remedy.

Price is a consideration. The gadget’s maker at present lists its commonplace value as $499, and states that it isn’t coated by medical insurance. It does include a 60-day money-back assure, which may assist customers determine if it’s definitely worth the value.

Lastly, there’s the time dedication. To forestall migraines, customers are suggested to use the gadget for 20 minutes every day. For remedy of acute headache, a 60-minute remedy is beneficial.

The underside line

This remedy has been round since no less than 2014 and is actually no treatment. So, electrical stimulation for migraine can hardly be thought of a recreation changer for many migraine victims. But it surely appears to me it’s not empty hype both. There’s affordable proof that it’s secure and no less than considerably efficient.

The latest motion by the FDA to make the Cefaly Twin out there with out a prescription ought to make it extra accessible. And, by any measure, a modestly efficient, drug-free method to deal with migraine is a optimistic improvement. Hopefully, future research of this gadget will make clear who’s most probably to learn by utilizing it. However we’d like even higher choices. Advances in our understanding of how migraines develop and ongoing analysis ought to present them.

Observe me on Twitter @RobShmerling

The publish Migraine headaches: Could nerve stimulation help? appeared first on Harvard Health Blog.

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