Non-Invasive Vagus Nerve Stimulation to Treat Migraines

Neuromodulation in Migraine Treatment and Prevention

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Consider Easing Your Migraine with a Transcutaneous Vagus Nerve Stimulator. David De Lossy/Getty Images

Several noninvasive neuromodulation devices use electrical or magnetic stimulation for migraine treatment and prevention. You need a physician's prescription to obtain any of these devices, but they do not require a procedure and you can self-administer the treatment once you learn how to use it.

Advantages include fewer reported side effects than medication, and disadvantages include out-of-pocket cost (some are not covered by all health insurance plans) and a relatively short track record when it comes to efficacy (how well they work) and potential side effects.

If you have migraines, it is a good idea to familiarize yourself with the new migraine treatment and prevention devices that you might want to consider.

Types of Neuromodulation for Treating Migraines

Products that use electrical stimulation are directed at specific nerves in or near the brain, including the vagal nerve or supraorbital nerve. Magnetic stimulation is directed to the whole brain and is not focused on a specific nerve.

It isn't clear yet whether one device is better than another, or whether there are features of your headaches that could make one device more advantageous than another.

But so far, the different neuromodulation techniques for migraines have not been used together and compatibility between devices has not been tested. So it is not a good idea to try more than one device at a time, because you may experience a negative outcome.

Vagus Nerve Stimulation

The gammaCore device, approved by the United States Food and Drug Administration (FDA), is a hand-held device designed to be placed on the surface of your skin for two minutes during an acute migraine or cluster headache episode. When placed where your vagus nerve runs in your neck, it electrically stimulates the nerve through the skin.

The vagus nerve moderates heart rate, blood pressure, and breathing. It also plays a role in pain, and it is believed that this type of neurostimulation may alter the way the vagus nerve mediates pain during migraines or cluster headaches.

Vagus nerve stimulation, using a surgically implanted device, has been used for the treatment of some epilepsy disorders and for depression, but vagus nerve stimulation for migraine is different because it does not involve interventional placement of the device.

The treatment is not recommended if you have a heart condition or blood pressure problems, if you have had surgery in the region of your vagus nerve, or if you have any implantable electric device. It is also not recommended for children and pregnant women.

Supraorbital Nerve Stimulation

Cefaly is a transcutaneous supraorbital nerve stimulation (t-SNS) device that is FDA-approved for migraine prevention and treatment. It is designed to be positioned on the skin of the forehead. It consists of a battery-powered stimulator and an electrode pad that sticks to the center of the forehead. 

When used for prevention, it used daily for 20-minute sessions, and when used for an acute attack, it is used for 60 minutes.

The supraorbital nerve mediates sensation of part of the forehead, the scalp, upper eyelid, and frontal sinus. It is a branch of the trigeminal nerve, which is believed to play a role in migraine pain.

Cefaly is considered safe, but it can cause tingling, sleepiness, skin irritation, and headaches.

Transcranial Magnetic Stimulation for Treating Migraines

The transcranial magnetic stimulator (TMS) is FDA-approved for treatment of episodes of migraine with aura. After properly positioning the device against the back of the head, it is activated with a button to release magnetic stimulation superficially to the skull. The magnetic activity is believed to interact with nerves in the brain to stop or reduce migraine pain.

Some people experience dizziness as a result of using the device.

A Word From Verywell

Neuromodulation is a non-invasive, easy to use, and safe approach to migraine management. Benefits include avoiding side effects of migraine medications, including medication overuse headaches. The downsides include a paucity of scientific data and the expense.

Migraines undoubtedly interfere with quality of life, but the range and types of treatment options are growing. As you work with your doctor to find the right fit for you, one of the new devices may turn out to be your best option.

Neuromodulation can be used along with migraine medication, and using one of these methods can help you reduce the frequency and dose of medication that you need to take.

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