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Early-use remote electrical stimulation offers rapid migraine relief

Migraine Migraine
Migraine Migraine

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Nonpainful remote electrical stimulation effectively reduces migraine pain, especially with early use, offering a safe, non-pharmacologic, and cost-effective treatment option.

A recent randomized, crossover, sham-controlled trial depicted that remote electrical stimulation applied to the upper arm can markedly curtail migraine pain, offering a potential non-pharmacologic solution for those suffering from this debilitating condition. This study explored the usefulness of nonpainful electrical stimulation of the skin using a portable device, aimed at providing relief during the early stages of a migraine attack.

In this prospective and double-blinded study, 71 subjects affected with episodic migraines (totalling 299 treatments) were randomly allocated to get either active or sham stimulation. The enrolled subjects were instructed to apply skin electrodes to their upper arms promptly after the onset of a migraine attack. Each session lasted for 20 minutes, during which various pulse widths (200-μs, 150-μs, and 100-μs) were examined. The volunteers refrained from taking medications for 2 hours prior to and after treatment. This allowed the effects of the electrical stimulation to be assessed without confounding factors.

The study’s results indicated a substantial benefit of active stimulation over placebo:

  • 50% pain mitigation was attained by 64% of volunteers when using active stimulation at pulse widths of 200-μs, 150-μs, and 100-μs, as opposed to just 26% in the sham (placebo) group.
  • Of participants who started with severe or moderate pain, 58% (25 out of 43) experienced a reduction to mild or no pain when treated with the 200-μs pulse width. This was in stark contrast to only 24% (4 out of 17) in the placebo group.
  • Additionally, 30% of volunteers (13 out of 43) in the active stimulation group reported complete pain relief (no pain), compared to just 6% (1 out of 17) in the placebo group. This difference was statistically significant, with a p-value of 0.004 for the reduction to no pain and p = 0.02 for the reduction to mild pain or no pain.
  • Early application of the electrical stimulation—within 20 minutes of attack onset—yielded prominently better results, with a 46.7% pain alleviation compared to a 24.9% alleviation when treatment was delayed. The statistical significance of this finding was substantiated with a p-value of 0.02.

The mechanism by which remote electrical stimulation ameliorates migraine pain is believed to involve the activation of descending inhibition pathways through a process called conditioned pain modulation (CPM). CPM is a natural phenomenon where the body inhibits pain through higher-level neural pathways, aiding to regulate and reduce pain perception. This suggests that the nonpainful electrical stimulation may modulate the pain pathways in a way that remarkably minimizes the intensity of migraine pain.

The results suggest that nonpainful remote skin electrical stimulation can be a highly useful therapy for addressing the pain linked with episodic migraines, particularly when applied early in the attack. The treatment is noninvasive, easy to use, free from adverse side effects, and cost-effective, making it an appealing option for those seeking alternatives to traditional pharmacologic treatments. Given its potential to offer substantial pain relief and its favorable safety profile, this approach can become a valuable addition to the toolkit for tackling migraines, especially in those seeking non-pharmacologic options.

Source:

Neurology

Article:

Nonpainful remote electrical stimulation alleviates episodic migraine pain

Authors:

David Yarnitsky et al.

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