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Non-invasive neuromodulation therapies are effective and safe, but high-quality randomized controlled trials are to be performed to sustain their use.
A recent evidence-based study by Sarah Miller and colleagues’ states that although various open-label series of non-invasive neuromodulation devices have been reported to date, the controlled evidence of their use in any headache treatment is limited.
Neuromodulation therapy is a cross-disciplinary approach towards pain control and neurologic dysfunctions. The therapy involves stimulation of the body's nervous system with electric signals for therapeutic purposes. The therapy comprises two types of modalities, invasive and non-invasive. Invasive modalities comprise deep brain stimulation, occipital nerve stimulation and sphenopalatine ganglion stimulation. These therapies are often used in case of severe and intractable patients. The non-invasive modalities include transcranial magnetic nerve stimulation (TMS) and vagal nerve stimulation (nVNS). These non-invasive modalities are used in the treatment of primary headaches like trigeminal autonomic cephalalgias and migraine.
Few open-label pieces of evidence have proposed that the nVNS therapy is effective in treatment for cluster headaches and migraine. However, the evidence in accordance with this is insufficient. The other therapy, nSONS is helpful in migraine treatment, but no evidence is found regarding its role in headache prevention. On the other hand, TMS was reported to be effective in migraine, but not in case of headache.
On the basis of the whole evidence-based study, it was found that non-invasive neuromodulation therapies were effective and safe, but high-quality randomized controlled trials did not yet sustain their use.
Current Pain and Headache Reports
Non-invasive Neuromodulation in Primary Headaches
Sarah Miller, Manjit Matharu
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