“Reduction in headache days is a useful end point, because when you’ve got a migraine, it’s a bad day. And if you’ve got a probable migraine, then it’s not a great day either. So if you could reduce those, it would seem like a useful thing,” Dr. Goadsby commented. “It’s a question of whether you want to be glass half-full or glass half-empty about this. You could say there were two trials, and one failed its primary end point, so that’s it. On the other hand, there are a lot of unmet needs in chronic migraine, and if you could do some good and it’s not going to cause too much trouble, you might want to think about that.”
Neurostimulation Devices
Devices and other techniques being studied for the treatment and prevention of migraine include occipital nerve stimulation (ONS), the Precision Implantable Stimulator for Migraine (PRISM), the Bion microstimulator, and repetitive transcranial magnetic stimulation (rTMS).
For example, a small study regarding the Bion, which is “the size of two matchsticks stuck together,” Dr. Goadsby noted, found that a handful of patients had “spectacular results from this small device.”
Further studies on these devices are needed, he said, adding, “We are still learning how to get the stimulation right.”
—Rebecca K. Abma