Migraine is a prevalent and disabling diseases, affecting approximately 9% of children and adolescents. Migraine in adolescents has been associated with missed school days, poorer performance in school, negative effect on social interactions, and negative impact on quality of life. The majority of current migraine acute treatments for adolescents are pharmacological. Yet these treatments may not always be effective, they can cause side effects, and their overuse may lead to medication overuse headache and migraine chronification. Remote electrical neuromodulation (REN) is a non-pharmacological treatment, that provides significant symptom relief with good tolerability.

Within-participant post-hoc analysis was performed on data (n=35 adolescents) from a clinical trial of REN. Efficacy was compared (Mc’Nemar’s test) between standard-care medications (run-in phase; triptans or over the counter medications, according to patient preference), and REN treatment (intervention phase) at four endpoints (two hours post-treatment): single-treatment pain freedom and pain relief, and consistency of pain freedom and pain relief (response in at least 50% of the available first four treatments).

At two hours post-treatment, pain freedom was achieved by 37.1% of the participants with REN, vs. 8.6% of the participants with medications (p=0.004). Pain relief was achieved by 71.4% with REN, vs. 57.1% with medications (p=0.225). Consistency of pain freedom was achieved by 40% with REN, vs. 8.6% with medications (p<0.001). Consistency of pain relief was achieved by 80.0% with REN, vs. 57.2% with medications (p=0.033).

REN may have higher efficacy than certain standard-care medications for the acute treatment of migraine in adolescents. A larger scale, blinded, comparative effectiveness and tolerability study is needed.