How Stimulating Your Brain Could Help Your Migraines

Safe, Non-invasive Migraine Therapies That May Be Worth a Try

Stimulating Nerves to Soothe Your Headaches
Stimulating Nerves to Soothe Your Headaches. Henning Dahloff/Getty Images

If your migraines are not responding to traditional migraine preventive and abortive medications, your headache specialist may consider an alternative therapy called neurostimulation — a technique that entails using electric currents to stimulate nerve cells so they stop transmitting pain signals. 

Types of Neurostimulation for Treating Migraines

Electrical stimulation of the following nerves has been used to treat migraines:

  • vagal nerve
  • supraorbital nerve
  • occipital nerve 
  • sphenopalatine ganglion

Vagus nerve stimulation has been found to be effective in treating seizure disorders and depression, and small studies have examined its effectiveness in treating migraines.

One 2014 study in Cephalagia examined 30 migraineurs over a six-week period. The participants were instructed to apply a hand-held device (called a non-invasive vagal nerve stimulation or gammaCore)  to an area of the neck that correlates with the right cervical branch of the vagus nerve. Forty-seven percent of the participants noted pain relief after using the device, and 21 percent were pain-free two hours after using the device.

Another 2015 study in the Journal of Headache and Pain examined 50 migraineurs who used the same device (the gammaCore). Results showed that about half of the participants had pain relief two hours after treatment with the device, and 23 percent had no pain after two hours — similar findings to the first study.

While these results are not earth-shattering, and the studies are small, the gammaCore device is patient-friendly, safe, and offers a reasonable alternative to migraine medication. All in all, larger studies will be helpful in determining its true utility. 

The supraorbital nerve supplies part of the forehead and scalp, upper eyelid, and frontal sinus, and transcutaneous supraorbital nerve stimulation (t-SNS) is currently FDA-approved for migraine prevention. The device used to stimulate the suproaorbital nerve is a battery-powered headband-like device. It consists of an electrode pad that sticks to the center of the forehead and is held in place by a plastic headband. 

The device can be used for people with migraines with or without aura and is approved for daily 20-minute sessions in the United States, meaning you use it daily to prevent migraines, not treat a migraine once its occurs.

The good news is that the device is also user-friendly and safe with few reported side effects. In addition, it has been found in studies to reduce the number of migraine days (by about a quarter), but it's still not as effective as certain migraine preventive medications, like Topamax (topiramate)

In terms of occipital nerve stimulation (the occipital nerve is located in the back of the head), studies have not been as promising for reducing migraine onset or pain. With that, occipital nerve stimulation is not currently FDA-approved for treating migraines.

Similarly, sphenopalatine ganglion (SPG) stimulation is also not currently FDA-approved for treating migraines, but the reason has to do more with the lack of studies than non-promising studies.

The technique studied for SPG entails implanting a device through the roof of the mouth behind the cheek. A patient then places a cell phone-like instrument near their cheek to release an electric current to mitigate pain — sounds like a science fiction movie, but it really exists (and is approved in Europe for chronic cluster headache). 

Transcranial Magnetic Stimulation for Treating Migraines

The transcranial magnetic stimulator (TMS) is FDA-approved for treatment of migraine with aura. This device is only available by prescription for adults and is used after the pain of a migraine begins. A migraineur uses it by applying the device against the back of their head. After properly positioning the device, the person presses a button which releases stimulating magnetic energy into the brain to stop or reduce migraine pain. The good news is that this device is well-tolerated with rare side effects (some people experience dizziness).

The Bottom Line

Understanding the true benefit of stimulating therapies for migraines requires larger scientific studies. That being said, stimulating therapies and their affiliated devices are non-invasive, easy to use, and offer minimal risks to the migraineur.

In addition, these devices offer other possible benefits, like helping patients avoid medication overuse headaches and uncomfortable side effects associated with some of the migraine medications.

The downside at this time (besides the somewhat paucity of scientific data) is the expense — your insurance may not cover the device, which means breaking out your checkbook (never a pleasant task). 

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Article Sources
  • Barbanti, P., Grazzi, L., Egeo, G., Padovan, A.M., Liebler, E., & Bussone, G. (2015). Non-invasive vagus nerve stimulation for acute treatment of high-frequency and chronic migraine: an open-label study. The Journal of Headache and Pain, 16:61. 
  • Goadsby, P.J., Grosberg, B.M., Mauskop, A., Cady, R., & Simmons, K.A. (2014). Effect of noninvasive vagus nerve stimulation on acute migraine: an open-label pilot study. Cephalalgia, Oct;34(12):986-93.
  • Lipton, R.B., et al. (2010). Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial. The Lancet Neurology, Apr;9(4):373-80.
  • Schwedt, T.J. & Vargas, B. (2015). Neurostimulation for treatment of migraine and cluster headache. Pain Medicine, Sep;16(9):1827-34. 
  • Tepper, D. American Headache Society. Headache Toolbox: Transcutaneous Supraorbital Neurostimulation (tSNS)