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Abstract Details

Non-Invasive Vagus Nerve Stimulation (nVNS) for Acute Treatment of Migraine: An Open-Label Pilot Study
Headache
S40 - (-)
004
Despite many acute treatment options for migraine, substantial unmet need remains. VNS is promising, but relatively unexplored.
Participants with migraine with or without aura, as defined by the International Classification of Headache Disorders- second edition, were eligible for an open-label, single arm, multiple attack study. Participants acutely treated up to 4 migraine attacks with a portable VNS within 6 weeks. Treatment consisted of two, 90-second doses, at 15-minute intervals delivered to the right cervical branch of the vagus nerve. Subjects were asked to self-treat once pain became moderate or severe, or after 20 minutes of mild pain.
Of 30 enrolled patients, (5M, 25F, average age 39), 26 eligibly treated 79 migraine headaches . At two hours, headache response rate (pain mild or absent at 2 hours) was 46/79 (58%), and 22/79 (28%) were pain free. Average initial pain level was a 1.84 (0-no pain, 1-mild, 2-moderate, 3-severe pain), and dropped 35%, to 1.20 (p<0.0001) by 2 hours . At two hours, 76 of 79 (96%) were improved or had not worsened over baseline. Of 26 patients 20 (77%) responded, i.e., reported mild or nor pain at 2 hours, for at least one treated headache. Among this subset of 20 patients 47/61 (77%) of their treated headaches responded. Treatment related adverse effects were limited to transient muscle or local tissue irritation, and two reports of light headedness, most of which resolved immediately after treatment, and all within two hours of treatment.
These results suggest that nVNS may be an effective and well-tolerated acute treatment for migraine in a responsive subgroup. Randomized controlled trials are warranted.
Authors/Disclosures
Peter Goadsby, MD, PhD, FRS (University of California, Los Angeles)
PRESENTER
Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli-Lilly. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aurene. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva Pharmaceuticals. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Pfizer. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CoolTech LLC. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PureTech Health LLC. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vial. Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aeon Biopharma. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Massachusetts Medical Society. The institution of Dr. Goadsby has received research support from NIHR. The institution of Dr. Goadsby has received research support from Kallyope. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has a non-compensated relationship as a Trustee with Migraine Trust that is relevant to AAN interests or activities. Dr. Goadsby has a non-compensated relationship as a Trustee with Organisation for Understanding Cluster Headache (UK) that is relevant to AAN interests or activities. Dr. Goadsby has a non-compensated relationship as a Executive roles with American Headache Society that is relevant to AAN interests or activities.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine) Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
No disclosure on file
Alexander A. Mauskop, MD, FAAN (New York Headache Center) Dr. Mauskop has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Allergan. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lily. Dr. Mauskop has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Brian Grosberg, MD (Hartford HealthCare Headache Center) Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Linpharma pharmaceuticals. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Theranica . Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Grosberg has stock in Theranica. The institution of Dr. Grosberg has received research support from Theranica. The institution of Dr. Grosberg has received research support from Amgen. The institution of Dr. Grosberg has received research support from Abbvie. The institution of Dr. Grosberg has received research support from Eli Lilly. The institution of Dr. Grosberg has received research support from Teva. The institution of Dr. Grosberg has received research support from Neurolief. Dr. Grosberg has received publishing royalties from a publication relating to health care.
No disclosure on file