Noninvasive Neuromodulation in Migraine

Author: Benzion Blech1, Amaal J Starling2
Affiliation: <sup>1</sup> Department of Neurology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA. blech.benzion@mayo.edu. <sup>2</sup> Department of Neurology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Conference/Journal: Curr Pain Headache Rep
Date published: 2020 Dec 16
Other: Volume ID: 24 , Issue ID: 12 , Pages: 78 , Special Notes: doi: 10.1007/s11916-020-00914-3. , Word Count: 155


Purpose of review:
The past two decades has seen an influx of noninvasive neuromodulation devices aimed at treatment of various primary headache disorders, including cluster headache and migraine. This narrative review is to summarize the current options in noninvasive neuromodulation in migraine.

Recent findings:
A variety of noninvasive neuromodulation devices have been FDA cleared and marketed for use in migraine, including single-pulse transcranial magnetic stimulation (sTMS), noninvasive vagal nerve stimulators (nVNS), and external trigeminal nerve stimulators (eTNS). Newer devices include peripheral electrical stimulation devices (PES), caloric stimulation, and others. Each has varying levels of evidence supporting its use in migraine, tolerability profiles, and access issues. Noninvasive neuromodulation devices can be beneficial when used in patients with migraine, with minimal side effects. As more devices are developed, approved, and marketed in the future, rigorous research on efficacy and safety remain a top priority.

Keywords: Migraine; Neurostimulation; Noninvasive; eTNS; nVNS; sTMS.

PMID: 33326063 DOI: 10.1007/s11916-020-00914-3