Abstract Details

Title A Systematic Review of Clinical Outcomes Utilizing Combined Occipital Nerve (ONS) and Supraorbital Nerve (SON) Stimulation in the Treatment of Chronic Migraine

Topic Headache

Presentation(s) P7 - Poster Session 7 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-008

Objective

Perform a systematic literature review of combined occipital and supraorbital (V1) stimulation in the treatment of chronic migraine.

Background

Neuromodulation of somatic nerves in the head has been shown to be effective in the treatment of multiple headache types including chronic migraine. It has been suggested that combined occipital and supraorbital nerve stimulation may provide benefit in chronic migraine.

Design/Methods A systematic literature review was performed to examine the clinical outcomes of combined occipital and supraorbital trigeminal (V1) stimulation for chronic migraine. Appropriate specified search terms, developed a priori, were utilized in conjunction with Pubmed, EMBASE, and Google Scholar. Back searches through cited references were also utilized. Due to the relatively small anticipated literature base, all published items that utilized combination were included in the review.

Results Fourteen (14) publications including a total of n=331 patients were obtained through the systematic review. Clinical outcomes demonstrated a wide range of responder rates (42-100%) due to a number of factors including system technology (implantable versus non-implantable), headache severity, and outcomes timelines. A subset of 12 published items focused on implantable neuromodulation therapies (n=254 patients). For patients with chronic migraine, the weighted average responder rate (>50% reduction) was 82.8% for headache severity (range 50-100%, n=222 patients) with a weighted 73.7% average reduction in headache days (range 73-92%, n=185 patients). Adverse events most commonly included lead migration and fracture (9-45%) as well as infection (5-27%).

Conclusions

Prior published research has shown promising outcomes in terms of reducing both headache severity and headache days in patients implanted with neurostimulators combining ONS and SON. While the potential therapeutic utility has shown promise, additional research is needed to better identify patient responders, optimize stimulation paradigms, and improve technologies to overcome device-related limitations.

Authors/Disclosures
Jeff Kramer PRESENTER	No disclosure on file
Brian Grosberg, MD (Hartford HealthCare Headache Center)	Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Linpharma pharmaceuticals. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Theranica . Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Grosberg has stock in Theranica. The institution of Dr. Grosberg has received research support from Theranica. The institution of Dr. Grosberg has received research support from Amgen. The institution of Dr. Grosberg has received research support from Abbvie. The institution of Dr. Grosberg has received research support from Eli Lilly. The institution of Dr. Grosberg has received research support from Teva. The institution of Dr. Grosberg has received research support from Neurolief. Dr. Grosberg has received publishing royalties from a publication relating to health care.
Samer Narouze	No disclosure on file

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