Transcutaneous Supraorbital Nerve Stimulation (t-SNS) with the Cefaly® Device for Migraine Prevention: A Review of the Available Data

  title={Transcutaneous Supraorbital Nerve Stimulation (t-SNS) with the Cefaly{\textregistered} Device for Migraine Prevention: A Review of the Available Data},
  author={Franz Riederer and Sophie Penning and Jean Schoenen},
  journal={Pain and Therapy},
  pages={135 - 147}
So far, among the different non-invasive neurostimulation methods, only transcutaneous supraorbital nerve stimulation (t-SNS) with the Cefaly® (Cefaly Technology sprl, Herstal, Belgium) device has randomized controlled trial-based evidence for safety and efficacy and obtained American Food and Drug Administration approval for the prevention of episodic migraine. [] Key Result In a double-blinded, randomized, sham-controlled trial on 67 episodic migraine patients (mean pre-treatment migraine days/month: 6.9…
[Neurostimulation of the supraorbital nerve with the Cefaly device - a new method for the treatment of migraine].
  • G. Tabeeva
  • Medicine, Psychology
    Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
  • 2019
Stimulation of the supraorbital nerve with the percutaneous Cefaly device in clinical randomized, controlled studies has demonstrated efficacy in significantly reducing both the frequency of migraine attacks and the total number of days with headache.
Clinical experience with transcutaneous supraorbital nerve stimulation in patients with refractory migraine or with migraine and intolerance to topiramate: a prospective exploratory clinical study
Three-months of preventive treatment for episodic or chronic migraine with t-SNS proved to be an effective, safe and well tolerated option for the treatment of patients with migraine who were intolerant or did not respond to topiramate.
Noninvasive neuromodulation of supraorbital and occipital nerves as an adjunct to management of chronic headache: A pilot study
Noninvasive neuromodulation may serve as a safer and cost-effective treatment option in CDH refractory to conservative management and changes were observed in the quality of life of patients.
Effect of Cervical Mobilization and Transcutaneous Supraorbital Nerve Stimulation in Migraine Without Aura
It can be concluded that cervical mobilization and Transcutaneous Supraorbital nerve stimulation can be added as a valuable adjunct to medical management in the treatment of migraine without aura.
Supraorbital electrical stimulation in management of chronic type tension headache: A randomized controlled study
  • N. Hamed
  • Medicine
    Physiotherapy theory and practice
  • 2018
SOES had positive therapeutic results for treatment of chronic type tension headache, and patients in groups A and B reported less headache frequencies than group C.
A Short Review of the Non-invasive Transcutaneous Pericranial Electrical Stimulation Techniques and their Application in Headache
A variety of neuromodulatory approaches is expanding fastly and has opened new possibilities for treatment of patients suffering from many forms of headache, especially those who have failed traditional pharmacotherapy.
External trigeminal nerve stimulation: Potential rescue treatment for acute vestibular migraine
  • S. Beh
  • Medicine, Psychology
    Journal of the Neurological Sciences
  • 2020
Effects of external trigeminal nerve stimulation (eTNS) on laser evoked cortical potentials (LEP): A pilot study in migraine patients and controls
The present results could suggest that the external transcutaneous nerve stimulation may interfere with the threshold and the extent of trigeminal system activation, with a mechanism of potential utility in the resolution and prevention of migraine attacks.
Determination of Current Flow Induced by Transcutaneous Electrical Nerve Stimulation for the Treatment of Migraine: Potential for Optimization
The results imply that preferential targeting of the ST nerve is related to the mechanism of action, and if comparable targeting of all three nerves continues to hold promise, the extended V-shaped +CS montage presents an optimized configuration to explore in clinical studies.


Safety and patients’ satisfaction of transcutaneous Supraorbital NeuroStimulation (tSNS) with the Cefaly® device in headache treatment: a survey of 2,313 headache sufferers in the general population
This survey of 2,313 headache sufferers in the general population confirms that tSNS with is a safe and well-tolerated treatment for migraine headaches that provides satisfaction to a majority of patients who tested it for 40 days.
Transcutaneous supraorbital neurostimulation in “de novo” patients with migraine without aura: the first Italian experience
In patients experiencing a low frequency of attacks, significant improvements in multiple migraine severity parameters were observed following a brief period of high frequency tS NS, and tSNS may be considered a valid option for the preventive treatment of migraine attacks in patients who cannot or are not willing to take daily medications.
Migraine prevention with a supraorbital transcutaneous stimulator: A randomized controlled trial
It is proposed that acupuncture can predict the efficacy of STS: if acupuncture is effective, STS will also be effective and worth performing.
Non-invasive vagus nerve stimulation for acute treatment of high-frequency and chronic migraine: an open-label study
Non-invasive vagus nerve stimulation may be effective as acute treatment for HFEM or CM and may help to reduce medication overuse and medication-associated adverse events.
Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: Results from a randomized, multicenter, double-blinded, controlled study
Although this study failed to meet its primary endpoint, this is the first large-scale study of PNS of the occipital nerves in CM patients that showed significant reductions in pain, headache days, and migraine-related disability.
Supraorbital transcutaneous neurostimulation has sedative effects in healthy subjects
Supraorbital high frequency TNS applied with the Cefaly® device decreases vigilance in healthy volunteers, which opens interesting perspectives for the treatment of hyperarousal states and, possibly, insomnia.
Peripheral neurostimulation in primary headaches
The stimulation of the sphenopalatine ganglion has been used as a therapeutic target for the treatment of acute cluster headache attacks, with promising results and preliminary data in patients with epilepsy and migraine have suggested a potential efficacy of vagus nerve stimulation.
Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study.
The activation pattern in the dorsal rostral pons is highly suggestive of a role for this structure in the pathophysiology of chronic migraine and the localization and persistence of activity during stimulation is exactly consistent with a region activated in episodic migraine, and with the persistence of activation of that area after successful treatment.
Neurostimulation therapies for primary headache disorders: present and future.
Neurostimulation therapies inaugurate a new era in headache management and offer a promising alternative to medications, but future studies are necessary to provide evidence-based efficacy data, knowledge on their mode of action and information about their pharmaco-economic advantages.
Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study
The results of this feasibility study offer promise and should prompt further controlled studies of occipital nerve stimulation (ONS) in CM.