Neuromodulation for Chronic Daily Headache

Curr Pain Headache Rep. 2022 Mar;26(3):267-278. doi: 10.1007/s11916-022-01025-x. Epub 2022 Feb 7.

Abstract

Purpose of review: We reviewed the literature that explored the use of central and peripheral neuromodulation techniques for chronic daily headache (CDH) treatment.

Recent findings: Although the more invasive deep brain stimulation (DBS) is effective in chronic cluster headache (CCH), it should be reserved for extremely difficult-to-treat patients. Percutaneous occipital nerve stimulation has shown similar efficacy to DBS and is less risky in both CCH and chronic migraine (CM). Non-invasive transcutaneous vagus nerve stimulation is a promising add-on treatment for CCH but not for CM. Transcutaneous external trigeminal nerve stimulation may be effective in treating CM; however, it has not yet been tested for cluster headache. Transcranial magnetic and electric stimulations have promising preventive effects against CM and CCH. Although the precise mode of action of non-invasive neuromodulation techniques remains largely unknown and there is a paucity of controlled trials, they should be preferred to more invasive techniques for treating CDH.

Keywords: Deep brain stimulation; Direct current stimulation; Occipital nerve; Sphenopalatine ganglia; Transcranial magnetic stimulation; Trigeminal nerve; Vagus nerve.

Publication types

  • Review

MeSH terms

  • Cluster Headache* / therapy
  • Electric Stimulation Therapy* / methods
  • Humans
  • Migraine Disorders* / therapy
  • Transcranial Magnetic Stimulation / methods
  • Transcutaneous Electric Nerve Stimulation*
  • Vagus Nerve Stimulation* / methods