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Central and Peripheral Neural Targets for Neurostimulation of Chronic Headaches

  • Neuromodulation (M Gofeld, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Chronic headache sufferers are estimated to be around 3% of the population. These patients have a high disease burden. When prophylactic treatments have low efficacy and tolerability, patients are in need of alternative therapeutic strategies and options.

Recent Findings

In the last decade, a number of neuromodulation procedures have been introduced as treatment of chronic intractable headache patients when pharmacological treatments fail or are not well tolerated. Neurostimulation of peripheral and central nervous system has been carried out, and now, various non-invasive and invasive stimulation devices are available. Non-invasive neurostimulation options include vagus nerve stimulation, supraorbital stimulation and single-pulse transcranial magnetic stimulation; invasive procedures include occipital nerve stimulation, sphenopalatine ganglion stimulation and hypothalamic deep brain stimulation. In many cases, results supporting their use derive from open-label series and small controlled trial studies. Lack of adequate placebo hampers adequate randomized controlled trials.

Summary

In this paper, we give an overview on the main neurostimulation procedures in terms of results and putative mechanism of cation.

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Authors and Affiliations

  1. Department of Neurology, Headache Centre and Pain Neuromodulation Unit, Fondazione Istituto Nazionale Neurologico Carlo Besta, Via Celoria 11, 20133, Milano, Italy

    Massimo Leone & Alberto Proietti Cecchini

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  1. Massimo Leone
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  2. Alberto Proietti Cecchini
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Correspondence to Massimo Leone.

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Massimo Leone and Alberto Proietti Cecchini declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Neuromodulation

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Leone, M., Cecchini, A.P. Central and Peripheral Neural Targets for Neurostimulation of Chronic Headaches. Curr Pain Headache Rep 21, 16 (2017). https://doi.org/10.1007/s11916-017-0616-x

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