Migraine prevention with a supraorbital transcutaneous stimulator: A randomized controlled trial.

Schoenen et al.(1) provided evidence that trigeminal neurostimulation with a supraorbital transcutaneous stimulator (STS) is effective for migraine. STS involves the application of electrodes and stimulator via an invasive surgical procedure that includes expensive medical consumables and possible complications. Only 70.6% of patients are very satisfied or moderately satisfied and approximately 1 out of 5 was not satisfied after STS effective neurostimulation.(1) This means that 20%-30% of patients were dissatisfied with the procedure. Unfortunately, there is no way to preoperatively predict which patients will respond to the stimulation. STS has a sedative effect via a change in CNS activity.(1) Acupuncture (e.g., somatic acupuncture, ear acupuncture, or electroacupuncture) has been successfully used for migraine(2,3) and reduces sympathetic nerve activity.(4) Based on those data, we propose that acupuncture can predict the efficacy of STS: if acupuncture is effective, STS will also be effective. For migraineurs, inexpensive and minimally invasive acupuncture can be performed before the STS. If acupuncture is efficient, STS may also be efficient and worth performing.
PMID: 24042576