An Update on Non‐Pharmacological Neuromodulation for the Acute and Preventive Treatment of Migraine

  title={An Update on Non‐Pharmacological Neuromodulation for the Acute and Preventive Treatment of Migraine},
  author={Francesca Puledda and Peter J. Goadsby},
  journal={Headache: The Journal of Head and Face Pain},
  • F. PuleddaP. Goadsby
  • Published 1 April 2017
  • Medicine, Psychology
  • Headache: The Journal of Head and Face Pain
To review current neuromodulation treatments available for migraine therapy, both in the acute and preventive setting. 

Remote Electrical Neuromodulation (REN) Relieves Acute Migraine: A Randomized, Double‐Blind, Placebo‐Controlled, Multicenter Trial

To assess the efficacy and safety of a remote electrical neuromodulation (REN) device for the acute treatment of migraine, a large number of patients were referred for treatment with a single device.

Current Prophylactic Medications for Migraine and Their Potential Mechanisms of Action

A relatively high number of different medications used for migraine prevention in clinical practice differ in their mechanisms of action, but some general themes can be identified from the mechanisms at play.

Neuromodulation for the Acute and Preventive Therapy of Migraine and Cluster Headache

This review focuses on neuromodulation devices that have been studied for migraine and cluster headache, with special attention to those that have gained food and drug administration clearance and how these devices can be used in patients who might have limited pharmacologic options.

Review of evidence on noninvasive vagus nerve stimulation for treatment of migraine: efficacy, safety, and implications.

GammaCore treatment is both safe and effective as an acute treatment for migraine and provides substantial value to patients and to payers for consideration for pay-for-performance health coverage strategies and policies.

Emerging Treatments in Episodic Migraine

A number of new medications are emerging for the acute and preventive treatment of migraine, including CGRP monoclonal antibodies, C GRP receptor antagonists, serotonin 5-HT1F agonists, and PACAP receptor monoc Lonal antibodies.

Complementary and Integrative Medicine for Neurological Conditions: A Review

The use of selected, evidence based CAM therapies for the prevention and treatment of migraine, carpal tunnel syndrome, and dementia are presented.


There is a great unmet need for alternative acute migraine treatments that are both effective and well tolerated and non-invasive neuromodulation is safe, well tolerated, and may have fewer adverse effects than drugs.

Comment: Noninvasive neurostimulation for migraine should be part of the general neurologist's therapeutic armamentarium

The PRESTO study adds to the evidence that noninvasive vagus nerve stimulation is an effective acute treatment for migraine by producing higher pain-free rates than sham stimulation 30 minutes and 1 hour post-treatment.

Preventive Migraine Treatment

  • R. Burch
  • Medicine, Psychology
  • 2021
Many pharmacologic and nonpharmacologic treatment options are available for the prevention of migraine, including newer therapies aimed at the CGRP pathway as well as older treatments with good evidence for efficacy.



Migraine--current understanding and treatment.

The epidemiology, pathophysiology, and preventive and symptomatic treatment of migraine is described, with special attention to drug therapy with the triptans.

Peripheral Neurostimulation for the Treatment of Chronic, Disabling Transformed Migraine

This study analyzes clinical responses of transformed migraine to cervical peripheral nerve stimulation to find out whether these responses are related to migraines or not.

Intranasal Lidocaine for Migraine: A Randomized Trial and Open‐Label Follow‐up

Objective.—To study the efficacy of intranasal lidocaine for the treatment of migraine when administered by subjects in a nonclinic setting.

The Role of Noninvasive Neuromodulation in Migraine Management

This brief review aims at describing noninvasive neuromodulation techniques, which are currently the most used in clinical practice, specifically focusing on transcranial magnetic stimulation, vagus nerve stimulation and supraorbital nerve stimulation.

EFNS guideline on the drug treatment of migraine – revised report of an EFNS task force

Migraine is one of the most frequent disabling neurological conditions with a major impact on the patients’ quality of life and the use of medication to treat it is a major concern.

Acute Treatment of Intractable Migraine With Sphenopalatine Ganglion Electrical Stimulation

Preliminary results of a novel acute treatment for intractable migraine are reported, using the sphenopalatine ganglion, which has sensorimotor and autonomic components and is involved in migraine pathophysiology.

Intranasal Lidocaine to Prevent Headache Following Migraine Aura

The consistent effect of intranasal lidocaine 4% on preventing headache following aura in one individual is reported.

Transcranial Magnetic Stimulation for Migraine: A Safety Review

(Headache 2010;50:1153‐1163)

Transcranial magnetic stimulation and potential cortical and trigeminothalamic mechanisms in migraine

Migraine affects 1 billion people worldwide, and is the most common cause of neurological disability. Single pulse transcranial magnetic stimulation (sTMS) has been shown to be effective for the

Transcutaneous Vagus Nerve Stimulation (tVNS) for headache prophylaxis: initial experience

There is a need for non invasive therapies that could be justified in less disabled patients and internal Vagus Nerve Stimulation might be effective in headache prevention.