Noninvasive vagus nerve stimulation for migraine: a systematic review and meta-analysis of randomized controlled trials
Author: Dong Song1,2, Piaoyi Li1, Yonggang Wang2,3, Jin Cao1
Affiliation:
1 School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.
2 Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
3 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Conference/Journal: Front Neurol
Date published: 2023 May 11
Other:
Volume ID: 14 , Pages: 1190062 , Special Notes: doi: 10.3389/fneur.2023.1190062. , Word Count: 251
Background:
Medication is commonly used to treat migraine. However, patients may experience adverse events or fail to respond to medication. In recent years, neuromodulation techniques have emerged as potential non-pharmacological therapy for migraine. This article focuses on a systematic review and meta-analysis of randomized controlled trials of non-invasive vagus nerve stimulation (n-VNS) for migraine to determine the efficacy, safety and tolerability of n-VNS.
Methods:
We searched PUBMED, EMBASE, and Cochrane Center Register of Controlled Trials databases up to July 15, 2022. Primary outcomes were monthly reduced migraine/headache days, and pain-free rates within 2 h. Secondary outcomes were ≥ 50% responder rate, headache intensity, monthly acute medication reduction days, and adverse events.
Results:
Meta-analysis shows that non-invasive cervical vagus nerve stimulation (n-cVNS) significantly impacted ≥50% responder rate (OR, 1.64; 95% CI, 1.1 to 2.47; p = 0.02), but had no significant effect on reducing migraine days (MD, -0.46; 95% CI, -1.21 to 0.29; p = 0.23) and headache days (MD, -0.68; 95% CI, -1.52 to 0.16; p = 0.11). In contrast, low-frequency non-invasive auricular vagus nerve stimulation (n-aVNS) was found to significantly reduce the number of migraine days (MD, -1.8; 95% CI, -3.34 to -0.26; p = 0.02) and headache intensity (SMD, -0.7; 95% CI, -1.23 to -0.17; p = 0.009), but not the number of acute medication days per month (MD, -1.1; 95% CI, -3.84 to 1.64; p = 0.43). In addition, n-cVNS was found safe and well-tolerated in most patients.
Conclusion:
These findings show that n-VNS is a promising method for migraine management.
Keywords: curative effect; migraine; non-invasive auricular vagus nerve stimulation (n-aVNS); non-invasive cervical vagus nerve stimulation (n-cVNS); non-invasive vagus nerve stimulation (n-VNS).
PMID: 37251233 PMCID: PMC10213755 DOI: 10.3389/fneur.2023.1190062
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