PHILADELPHIA—A noninvasive device that provides vagal nerve stimulation (VNS) may reduce the pain of migraine, according to research presented at the 66th Annual Meeting of the American Academy of Neurology. The results of a small study indicate that the device may resolve approximately 45% of attacks within 30 minutes. More than half of patients who use the device may be pain-free or have moderate relief at 120 minutes.
Licia Grazzi, MD, a neurologist at Istituto Neurologico Carlo Besta in Milan, and colleagues enrolled 30 patients to study the gammaCore VNS device for the treatment of migraine attacks. All patients had migraine without aura, according to International Headache Society criteria, and had five to nine attacks per month. In the open-label study, patients treated three to five moderate to severe migraine attacks in three weeks with the gammaCore device. The device delivered a 90-second dose of stimulation to the right cervical branch of the vagus nerve. After treatment, participants recorded the level of pain every 30 minutes for 24 hours using a visual analog scale.
Licia Grazzi, MD
A total of 96 migraine attacks were treated, and 43 were resolved within 30 minutes. Forty-two attacks were not resolved during the first two hours after treatment, and patients used rescue medication. Eleven attacks were not completely resolved, but patients had moderate pain relief and did not use rescue medication for them. Results were deemed uncertain for these 11 attacks. Patients did not report any adverse events and were able to use the device effectively.
“These results suggest that a single [noninvasive] VNS treatment may be effective and well tolerated to treat migraine without aura in a significant percentage of attacks,” said Dr. Grazzi. “Randomized controlled studies are needed to further examine the optimal dosage for successful treatment of migraine without aura and the potential role of these nonpharmacologic methods to treat different categories of patients.”
—Erik Greb