6533b837fe1ef96bd12a29da
RESEARCH PRODUCT
Neuromodulation of chronic headaches: position statement from the European Headache Federation
Marina De TommasoStefano PalmisaniDenys FontaineFilippo BrighinaAndrea AntalTim P JürgensDelphine MagisWalter PaulusMax HeilandArne MayR. ArcioniRigmor JensenKoen PaemeleireMassimo LeonePaolo MartellettiAngelo Franzinisubject
TRANSCRANIAL MAGNETIC STIMULATIONDeep Brain Stimulationmedicine.medical_treatmentSPGSPINAL-CORD STIMULATIONDBSARTERIAL BLOOD-PRESSUREtDCS0302 clinical medicinechronic headachetmsVNSMedicine and Health Sciencesmigraine030212 general & internal medicineHUMAN MOTOR CORTEXeuropean headache federationVAGAL AFFERENT STIMULATIONTranscranial direct-current stimulationspgHeadacheEuropean headache federationcluster headacheHemicrania continuadbsGeneral MedicineTranscranial Magnetic StimulationNeuromodulation (medicine)3. Good healthConsensus ArticleChronic headachevnsSettore MED/26 - NeurologiaDEEP-BRAIN-STIMULATIONChronic PainHeadachesmedicine.symptomVagus nerve stimulationUNILATERAL NEURALGIFORM HEADACHEneurostimulationmedicine.medical_specialtyPOSTERIOR HYPOTHALAMIC AREACluster headacheHeadache DisordersTENSClinical NeurologyElectric Stimulation TherapyONS03 medical and health sciencesPhysical medicine and rehabilitationmedically intractable headachemedicineHumansdbs; spg; tdcs; tms; ons; medically intractable headache; migraine; european headache federation; neurostimulation; gon; cluster headache; tens; vns; chronic headacheGONNeurostimulationNeurostimulationMigraineOCCIPITAL NERVE-STIMULATIONtdcsMedically intractable headachebusiness.industryCluster headachemedicine.diseaseonsAnesthesiology and Pain MedicineMigraineTMSPhysical therapytensChronic headache; Medically intractable headache; Neurostimulation; SPG; DBS; GON; tDCS; TMS; ONS; TENS; VNS; Migraine; Cluster headache; European headache federationgonNeurology (clinical)businessCHRONIC CLUSTER HEADACHE030217 neurology & neurosurgerydescription
The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even medically intractable. When a definitive lack of responsiveness to conservative treatments is ascertained and medication overuse headache is excluded, neuromodulation options can be considered in selected cases.Here, the various invasive and non-invasive approaches, such as hypothalamic deep brain stimulation, occipital nerve stimulation, stimulation of sphenopalatine ganglion, cervical spinal cord stimulation, vagus nerve stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and transcutaneous electrical nerve stimulation are extensively published although proper RCT-based evidence is limited. The European Headache Federation herewith provides a consensus statement on the clinical use of neuromodulation in headache, based on theoretical background, clinical data, and side effect of each method. This international consensus further gives recommendations for future studies on these new approaches.In spite of a growing field of stimulation devices in headaches treatment, further controlled studies to validate, strengthen and disseminate the use of neurostimulation are clearly warranted. Consequently, until these data are available any neurostimulation device should only be used in patients with medically intractable syndromes from tertiary headache centers either as part of a valid study or have shown to be effective in such controlled studies with an acceptable side effect profile. peerReviewed
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-10-21 |