Efficacy and mode of action of external trigeminal neurostimulation in migraine.

Efficacy and mode of action of external trigeminal neurostimulation in migraine. Expert Rev Neurother. 2018 Jun 13;: Authors: Schoenen J, Coppola G Abstract INTRODUCTION: Available preventive drug treatments for migraine lack complete efficacy and often have unpleasant adverse effects. Hence their clinical utility and therapeutic adherence are limited. Hence, non-invasive neurostimulation methods applied over various peripheral sites (forehead, mastoid, upper arm, cervical vagus nerve) have raised great interest because of their excellent efficacy/tolerance profile. Amongst them external trigeminal nerve stimulation (eTNS) was first to obtain FDA approval for migraine therapy. Areas covered: All clinical trials of eTNS as preventive or acute migraine treatment published in extenso or presented at congresses are reviewed. The paper analyzes neuroimaging and neurophysiological studies on mechanisms of action of eTNS. As many of these studies point towards the anterior cingulate gyrus (ACC) as a likely eTNS target, the paper scrutinizes the available literature on the ACC implication in migraine pathophysiology. Expert Commentary: eTNS is a viable alternative to standard pharmacological anti-migraine strategies both for prevention and abortive therapy. eTNS could chiefly exert its action by modulating the perigenual ACC, which might also be of interest for treating other disorders like fibromyalgia or depression. It remains to be determined if this might be...
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research