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Neuromodulators for Primary Headache Disorders: A Review

Salkim, E; Demosthenous, A; (2020) Neuromodulators for Primary Headache Disorders: A Review. EC Neurology , 12 (8) pp. 223-236. Green open access

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Abstract

Primary headache disorders are among the most common and disabling globally. Pharmacological treatments are often insufficient, poorly tolerated, have side effects and the majority of patients are unable to complete their treatment. Understanding the neural pain pathways of these disorders has led to the development of alternative therapies. Electrical nerve stimulation is a form of pain modulation with few side effects for the treatment of primary headache disorders. Different neuromodulation approaches, both invasive and non-invasive, have rapidly led to new approaches for the treatment of patients suffering from headache, particularly those who have failed traditional pharmacotherapy. Non-invasive treatment methods are safe, practical and well-tolerated compared to alternatives. This paper details recent evidence-based advances in neuromodulators for primary headache disorders such as migraine and trigeminal autonomic cephalalgias (in particular, cluster headache) including non-invasive commercial devices used for migraine and cluster headache. The target neural structures, their advantages and disadvantages and their application in headache treatment are discussed. Examples of using neuromodulation to manage primary headache disorders are discussed. Both invasive stimulations e.g. of occipital and vagus nerves, the sphenopalatine ganglion, deep brain and spinal cord, and non-invasive, e.g. stimulation of the frontal, cervical and auricular vagus nerves, transcranial magnetic and transcranial direct current stimulation, are detailed.

Type: Article
Title: Neuromodulators for Primary Headache Disorders: A Review
Open access status: An open access version is available from UCL Discovery
Publisher version: https://www.ecronicon.com/ecne/ECNE-12-00756.php
Language: English
Additional information: Copyright © 2020 Enver Salkim and Andreas Demosthenous.This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Cluster Headache; Migraine; Neuromodulation Devices; Neurostimulation; Primary Headache
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Electronic and Electrical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10106971
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