Cluster headache attack remission with sphenopalatine ganglion Stimulation: experiences in chronic cluster headache patients through 24 months
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Cluster headache attack remission with sphenopalatine ganglion Stimulation: experiences in chronic cluster headache patients through 24 months. / Barloese, Mads C J; Jürgens, Tim P; May, Arne; Lainez, Jose Miguel; Schoenen, Jean; Gaul, Charly; Goodman, Amy M; Caparso, Anthony; Jensen, Rigmor Højland.
In: J HEADACHE PAIN, Vol. 17, No. 1, 12.2016, p. 67.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Cluster headache attack remission with sphenopalatine ganglion Stimulation: experiences in chronic cluster headache patients through 24 months
AU - Barloese, Mads C J
AU - Jürgens, Tim P
AU - May, Arne
AU - Lainez, Jose Miguel
AU - Schoenen, Jean
AU - Gaul, Charly
AU - Goodman, Amy M
AU - Caparso, Anthony
AU - Jensen, Rigmor Højland
PY - 2016/12
Y1 - 2016/12
N2 - BACKGROUND: Cluster headache (CH) is a debilitating headache disorder with severe consequences for patient quality of life. On-demand neuromodulation targeting the sphenopalatine ganglion (SPG) is effective in treating the acute pain and a subgroup of patients experience a decreased frequency of CH attacks.METHODS: We monitored self-reported attack frequency, headache disability, and medication intake in 33 patients with medically refractory, chronic CH (CCH) in an open label follow-up study of the original Pathway CH-1 study. Patients were followed for at least 24 months (average 750 ± 34 days, range 699-847) after insertion of an SPG microstimulator. Remission periods (attack-free periods exceeding one month, per the ICHD 3 (beta) definition) occurring during the 24-month study period were characterized. Attack frequency, acute effectiveness, medication usage, and questionnaire data were collected at regular clinic visits. The time point "after remission" was defined as the first visit after the end of the remission period.RESULTS: Thirty percent (10/33) of enrolled patients experienced at least one period of complete attack remission. All remission periods followed the start of SPG stimulation, with the first period beginning 134 ± 86 (range 21-272) days after initiation of stimulation. On average, each patient's longest remission period lasted 149 ± 97 (range 62-322) days. The ability to treat acute attacks before and after remission was similar (37 % ± 25 % before, 49 % ± 32 % after; p = 0.2188). Post-remission headache disability (HIT-6) was significantly improved versus baseline (67.7 ± 6.0 before, 55.2 ± 11.4 after; p = 0.0118). Six of the 10 remission patients experienced clinical improvements in their preventive medication use. At 24 months post insertion headache disability improvements remained and patient satisfaction measures were positive in 100 % (10/10).CONCLUSIONS: In this population of 33 refractory CCH patients, in addition to providing the ability to treat acute attacks, neuromodulation of the SPG induced periods of remission from cluster attacks in a subset of these. Some patients experiencing remission were also able to reduce or stop their preventive medication and remissions were accompanied by an improvement in headache disability.
AB - BACKGROUND: Cluster headache (CH) is a debilitating headache disorder with severe consequences for patient quality of life. On-demand neuromodulation targeting the sphenopalatine ganglion (SPG) is effective in treating the acute pain and a subgroup of patients experience a decreased frequency of CH attacks.METHODS: We monitored self-reported attack frequency, headache disability, and medication intake in 33 patients with medically refractory, chronic CH (CCH) in an open label follow-up study of the original Pathway CH-1 study. Patients were followed for at least 24 months (average 750 ± 34 days, range 699-847) after insertion of an SPG microstimulator. Remission periods (attack-free periods exceeding one month, per the ICHD 3 (beta) definition) occurring during the 24-month study period were characterized. Attack frequency, acute effectiveness, medication usage, and questionnaire data were collected at regular clinic visits. The time point "after remission" was defined as the first visit after the end of the remission period.RESULTS: Thirty percent (10/33) of enrolled patients experienced at least one period of complete attack remission. All remission periods followed the start of SPG stimulation, with the first period beginning 134 ± 86 (range 21-272) days after initiation of stimulation. On average, each patient's longest remission period lasted 149 ± 97 (range 62-322) days. The ability to treat acute attacks before and after remission was similar (37 % ± 25 % before, 49 % ± 32 % after; p = 0.2188). Post-remission headache disability (HIT-6) was significantly improved versus baseline (67.7 ± 6.0 before, 55.2 ± 11.4 after; p = 0.0118). Six of the 10 remission patients experienced clinical improvements in their preventive medication use. At 24 months post insertion headache disability improvements remained and patient satisfaction measures were positive in 100 % (10/10).CONCLUSIONS: In this population of 33 refractory CCH patients, in addition to providing the ability to treat acute attacks, neuromodulation of the SPG induced periods of remission from cluster attacks in a subset of these. Some patients experiencing remission were also able to reduce or stop their preventive medication and remissions were accompanied by an improvement in headache disability.
KW - Adult
KW - Cluster Headache
KW - Electric Stimulation Therapy
KW - Female
KW - Follow-Up Studies
KW - Ganglia, Parasympathetic
KW - Headache Disorders
KW - Humans
KW - Male
KW - Middle Aged
KW - Quality of Life
KW - Remission Induction
KW - Time Factors
KW - Journal Article
KW - Randomized Controlled Trial
U2 - 10.1186/s10194-016-0658-1
DO - 10.1186/s10194-016-0658-1
M3 - SCORING: Journal article
C2 - 27461394
VL - 17
SP - 67
JO - J HEADACHE PAIN
JF - J HEADACHE PAIN
SN - 1129-2369
IS - 1
ER -
