The online version of this article (https://doi.org/10.1186/s10194-017-0828-9) contains supplementary material, which is available to authorized users.
The data in this manuscript has previously been presented in abstract form at EHMTIC, Glasgow, 15–18 September, 2016 and will be presented in abstract form at INS, Edinburgh, May 27 – June 1, 2017.
Cluster headache (CH) is a disabling primary headache disorder characterized by severe periorbital pain. A subset of patients does not respond to established pharmacological therapy. This study examines outcomes of a cohort of mainly chronic CH patients treated with sphenopalatine ganglion (SPG) stimulation.
Patients were followed in an open-label prospective study for 12 months. Ninety-seven CH patients (88 chronic, 9 episodic) underwent trans-oral insertion of a microstimulator targeting the SPG. Patients recorded stimulation effect prospectively for individual attacks. Frequency, use of preventive and acute medications, headache impact (HIT-6) and quality of life measures (SF-36v2) were monitored at clinic visits. Per protocol, frequency responders experienced ≥ 50% reduction in attack frequency and acute responders treated ≥ 50% of attacks. HIT-6 responders experienced an improvement ≥ 2.3 units and SF-36 responders ≥ 4 units vs. baseline.
Eighty-five patients (78 chronic, 7 episodic) remained implanted and were evaluated for effectiveness at 12 months. In total, 68% of all patients were responders, 55% of chronic patients were frequency responders and 32% of all patients were acute responders. 67% of patients using acute treatments were able to reduce the use of these by 52% and 74% of chronic patients were able to stop, reduce or remain off all preventive medications. 59% of all patients were HIT-6 responders, 67% were SF-36 responders.
This open-label registry corroborates that SPG stimulation is an effective therapy for CH patients providing therapeutic benefits and improvements in use of medication as well as headache impact and quality of life.
Additional file 1: Figure S1. Effectiveness (pain relief or pain freedom) in the treatment of acute attacks in all patients and acute responders. (JPG 15 kb)10194_2017_828_MOESM1_ESM.jpg
Additional file 2: Table S1. Number of reported adverse events in the whole population (n = 97) from 0 to 365 days, total 336 events. (DOCX 13 kb)10194_2017_828_MOESM2_ESM.docx
Jensen RM, Lyngberg A, Jensen RH (2007) Burden of cluster headache. Cephalalgia 27:535–541. https://doi.org/10.1111/j.1468-2982.2007.01330.x CrossRefPubMed
Matharu MS, Goadsby PJ (2008) Trigeminal autonomic Cephalalgias: diagnosis and management. In: Silberstein SD, Lipton R, Dodick D (eds) Wolff’s headache other head pain, 8th edn. Oxford University Press, New York
Schoenen J, Jensen RH, Lantéri-Minet M, Láinez MJ, Gaul C, Goodman AM et al (2013) Stimulation of the sphenopalatine ganglion (SPG) for cluster headache treatment. Pathway CH-1: a randomized, sham-controlled study. Cephalalgia 33:816–830. https://doi.org/10.1177/0333102412473667 CrossRefPubMedPubMedCentral
Barloese MCJ, Jürgens TP, May A, Lainez JM, Schoenen J, Gaul C et al (2016) Cluster headache attack remission with sphenopalatine ganglion stimulation: experiences in chronic cluster headache patients through 24 months. J Headache Pain 17:67. https://doi.org/10.1186/s10194-016-0658-1 CrossRefPubMedPubMedCentral
Jürgens TP, Schoenen J, Rostgaard J, Hillerup S, Láinez MJ, Assaf AT et al (2014) Stimulation of the sphenopalatine ganglion in intractable cluster headache: expert consensus on patient selection and standards of care. Cephalalgia 34:1100–1110. https://doi.org/10.1177/0333102414530524 CrossRefPubMed
Assaf AT, Hillerup S, Rostgaard J, Puche M, Blessmann M, Kohlmeier C et al (2016) Technical and surgical aspects of the sphenopalatine ganglion (SPG) microstimulator insertion procedure. Int J Oral Maxillofac Surg 45:245–254. https://doi.org/10.1016/j.ijom.2015.09.023 CrossRefPubMed
Silberstein S, Tfelt-Hansen P, Dodick DW, Limmroth V, Lipton RB, Pascual J et al (2008) Guidelines for controlled trials of prophylactic treatment of chronic migraine in adults. Cephalalgia 28:484–495. https://doi.org/10.1111/j.1468-2982.2008.01555.x CrossRefPubMed
Dworkin RH, Turk DC, McDermott MP, Peirce-Sandner S, Burke LB, Cowan P et al (2009) Interpreting the clinical importance of group differences in chronic pain clinical trials: IMMPACT recommendations. Pain 146:238–244. https://doi.org/10.1016/j.pain.2009.08.019 CrossRefPubMed
Pietzsch JB, Garner A, Gaul C, May A (2015) Cost-effectiveness of stimulation of the sphenopalatine ganglion (SPG) for the treatment of chronic cluster headache: a model-based analysis based on the pathway CH-1 study. J Headache Pain 16:530. https://doi.org/10.1186/s10194-015-0530-8 CrossRefPubMed
- Sphenopalatine ganglion stimulation for cluster headache, results from a large, open-label European registry
Rigmor Højland Jensen
- Springer Milan
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
e.Med Kampagnen-Visual, Mail Icon II