Promising New Technology on Horizon for Migraine Patients

Ahmed

Promising new technology/biotechnology is on the horizon for migraine sufferers, according to one headache expert.

“Technological advancements are critically important in migraine because many of the pharmacological treatments have unwanted or intolerable side effects,” says Zubair Ahmed, MD, a headache specialist at Cleveland Clinic. “This is truly an exciting time in migraine treatment development. Never have we had so many different options to help treat a condition which is considered the greatest cause of disability in individuals under the age of 50 years old.”

According to Ahmed, one of the newest technologies uses neuromodulation.

“This is an excellent option for many because neuromodulatory devices have been shown to be much better tolerated, with far fewer side effects than traditional pharmacological medications,” he says. “Neuromodulation refers to the use of magnetic stimulators and currents to modulate electrical activity within the brain and preventing migraines altogether or stopping migraines after they occur.”

Geoffrey Rutledge, MD, PhD and chief medical officer at technology company HealthTap, agrees. “There are several neuromodulation devices on the market which treat migraines by influencing nervous system activity.”

FDA-approved devices that treat migraines include:

• Cefaly, a transcutaneous electrical nerve stimulation device that stimulates muscles on the forehead, which is reported to reduce the frequency of migraine headaches.
• Sprint TMS, a “transcranial magnetic stimulator” that delivers a pulsed magnetic field to the back of the head, which can abort the aura at the onset of a migraine attack.
• gammaCore, a non-invasive vagus nerve stimulator, that has been shown to reduce the pain of a specific type of migraine called cluster headache.

Additionally, the FDA recently approved an in-ear device which looks like a pair of headphones, developed by U.S. company Scion Neurostim. This device modulates vestibular nerves (nerves involved in hearing and balance).

“Functional MRI has shown that vestibular nerve pathways are intimately related with migraine pathology,” says Ahmed. “We can regulate these nerves by subtly changing the temperature within the ears.”

Another more recent advance is an investigational device from Israel-based Theranica Ltd. called Nerivio, a wireless arm band, which is worn on the arm like a blood pressure cuff.

“It is unique because it is the only neuromodulation device not applied to the head or neck,” says Ahmed. “This is important because migraine patients can often become very hypersensitive and devices worn on the head/neck can be uncomfortable to wear during a severe migraine attack.”

The most promising new technology/biotechnology is the production of monoclonal antibodies (immune cells) which target a migraine molecule found in the brain called calcitonin gene receptor peptide (CGRP), says Ahmed.

“This has been a tremendous step forward in understanding and finally being able to treat an underlying potential cause of migraine,” he says. “CGRP is elevated in migraine patients, and if patients are given an infusion of this molecule it brings about a migraine like attack. The CGRP monoclonal antibodies prevent this ‘migraine molecule’ from working.”

What makes the treatment unique is that instead of taking pills daily to prevent headaches, patients may be able to self-inject the treatment once per month or once every three months-just four times per year.

Finally, according to Rutledge, consider the absence of technology.

“Migraines can be triggered by head, neck, or eye strain from using devices, as well as from the light and sound produced by the device,” he says. “Paying attention to the types of devices, types of experiences, and way the devices are used, and maybe eliminating their use altogether, may be key to reducing migraines.”