Wireless Stimulation May Ease Migraine Pain
Non-painful remote skin stimulation can significantly reduce migraine pain, especially when applied early in an attack, according to a new study.
“This is presumably by activating descending inhibition pathways via the conditioned pain modulation effect,” the researchers said.
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In a prospective, double-blinded, randomized, crossover, sham-controlled trial, migraineurs applied skin electrodes to the upper arm soon after attack onset for 20 minutes, at various pulse widths, and refrained from medications for 2 hours. Investigators asked patients to use the device for up to 20 attacks.
Overall, in 71 patients with evaluable data, 50% pain reduction was obtained for 64% of participants based on best of 200-μs, 150-μs, and 100-μs pulse width stimuli per individual compared with 26% for sham stimuli. They found greater pain reduction for active stimulation compared with placebo. For those starting at severe or moderate pain, reduction to mild or no pain occurred in 58% (25/43) of participants (66/134 treatments) for the 200-μs stimulation protocol and 24% (4/17; 8/29 treatments) for placebo (p=0.02), and reduction to no pain occurred in 30% (13/43) of participants (37/134 treatments) and 6% (1/17; 5/29 treatments), for the 200-μs stimulation protocol and for placebo, respectively (p=0.004). Treatment within 20 minutes of attack onset yielded better results, with 46.7% pain reduction as opposed to 24.9% reduction when started later (p=0.02).
“If this investigational device gets the proper clearance and becomes available in the market, this opens a very patient-friendly, risk-free, drug-free, effective acute therapy for migraine,” said study author Alon Ironi, CEO and cofounder of Theranica, maker of the device.
The researchers will soon begin a multicenter, international study with this device that features a larger number of patients, according to Ironi.
—Mike Bederka
Reference:
Yarnitsky D, Volokh L, Ironi A, et al. Nonpainful remote electrical stimulation alleviates episodic migraine pain [published online March 1, 2017]. Neurology. doi: dx.doi.org/10.1212/WNL.0000000000003760.