Health
Vagus nerve stimulation is effective for acute headache pain, review results
Recent literature review on the use of non-invasive vagus nerve stimulation (nVNS) pain Headache relief adds more information about this Neuromodulatory therapy..
of Studies researched Efficacy and safety of vagal cervical branch peripheral nerve stimulation in primary headache disorder.
The authors found that primary headache disorders (migraine, cluster headache, tension headache) Main causes of disability.. Overall, the prevalence of tension-type headache is about 20.1%, migraine is about 14.7%, cluster headache is about 0.1%-0.4%.
The vagus nerve, the main parasympathetic branch of the autonomic nervous system, transmits or transmits sensory information to the brain.
“The mechanism of action of nVNS in the treatment of headaches is largely elusive and multifactorial,” the authors said. Neuromodulation. To their knowledge, this is the first meta-analysis investigating the efficacy of nVNS in these types of headaches, they said.
The authors searched the Medline, Embase, and CENTRAL databases and reported all results of treating headaches using nVNS in a randomized controlled trial (RCT) using a random effects model.
According to the study, a study was included if the population included patients diagnosed with primary headache disorder International classification of headache disorders (ICHD)-II or ICHD-III beta); intervention compared cervical nVNS with spoofed device treatment or standard treatment; When measured by a responder rate of 50% or higher, adverse event, or satisfaction
Researchers used the revised Cochrane tool to assess the risk of bias to determine study quality.
The literature search yielded 746 articles, of which 51 were reviewed by the author. Finally, 7 articles from 6 clinical trials were included in the review. Six trials included 983 randomized patients (486 in nVNS and 497 in controls).
In three trials migraine patients (Hmm = 634) and three other trials show cluster headaches (Hmm = 349). Women accounted for the majority of the migraine population, and men accounted for the majority of cluster headache participants. Prophylaxis rates ranged from 28.5% to 90%.
In five trials, the controls were sham with the same device and standard care, while one trial used only standard care. Treatment lasted 2 to 12 weeks.
Overall, the results showed that nVNS was effective in alleviating acute pain compared to camouflaged device treatment. Specifically, the results are:
- Painless within 30 minutes (odds ratio [OR], 2.27; 95% CI, 1.16-4.44; P = .02)
- Analgesia within 30 minutes (OR, 1.8; 95% CI, 1.17-2.78; P = .007)
- Analgesia at 60 minutes (OR, 1.93; 95% CI, 1.2-3.1; P = .006)
- Decreased substance abuse (OR, 0.61; 95% CI, 0.41-0.92; P = .02)
- Painless status in more than 50% of treated seizures (OR, 2.15; 95% CI, 1.27-3.66; P = .005)
There were no significant differences in the number of days of headache, adverse events), or satisfaction with nVNS and sham device treatment. In addition, we were unable to determine a responder rate above 50%.
However, due to the limited data, some unanswered questions remained and they needed a larger RCT, they said.
reference
Lai YH, Huang Y, Huang LT, Chen RM, Chen C. Non-invasive vagal stimulation of the cervix for migraine and cluster headache: a systematic review and meta-analysis. Nerve regulation.. Published online on March 12, 2020. doi: 10.1111 / ner.13122
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