Noninvasive vagus nerve stimulation may be an effective treatment of chronic cluster headache, according to a study published in Neurology.
The transcutaneous stimulation appeared to stop acute attacks of cluster headache and reduce the frequency of attacks, reported Peter J. Goadsby, MD, PhD, and colleagues.
Researchers collected data on 19 patients, 11 with chronic cluster headache and eight with episodic cluster headache. Seven of the patients were refractory to drug treatment. The gammaCore device was used on the patients to both treat acute attacks and prevent future attacks for us to 52 weeks of continuous use.
Overall estimated mean improvement was 48%, with 15 patients reporting an overall improvement in their condition and four reporting no change. Among all attacks treated, 47% were aborted within an average of 11 ± 1 minutes from starting stimulation with the device. Ten patients reduced their use of high-flow oxygen by 55%, and nine reduced triptan use by 48%.
Prophylactic use of the gammaCore device reduced the estimated mean cluster headache attack frequency from 4.5/24 hours to 2.6/24 hours (P < 0.0005) after treatment.
The researchers suggest that further sham-controlled studies be done to validate the efficacy of noninvasive vagus nerve stimulation for cluster headache treatment and prevention.
This study aimed to evaluate the initial experience with a novel device, designed to provide portable, noninvasive, transcutaneous stimulation of the vagus nerve, both acutely and preventively, as a treatment for cluster headache.
Patients with cluster headache (11 chronic, 8 episodic), from 2 centers, including 7 who were refractory to drug treatment, had sufficient data available for analysis in this open-label observational cohort study. The device, known as the gammaCore, was used acutely to treat individual attacks as well as to provide prevention. Patient-estimated efficacy data were collected by systematic inquiry during follow-up appointments up to a period of 52 weeks of continuous use.