Implantable Device Reduces Migraine Headaches

The St. Jude Medical (Little Canada, MN, USA) Genesis neurostimulator is a compact 8-contact primary cell implantable pulse generator (IPG) system with efficient circuitry and a high-capacity battery. The stopwatch-sized device is implanted in the upper chest or abdomen, and a lead wire extends to the occipital nerves at the back of the head. The system is designed to deliver constant electrical energy to these nerves, which studies suggest hold a role in how patients experience pain from migraine headaches. In a recent study, 157 patients who suffered an average of 26 headaches per month were implanted with the Genesis and then randomly assigned to an active or control group for 12 weeks.

The active group received stimulation immediately, while the control group did not receive stimulation until after the first 12 weeks. The results showed that the patients who received stimulation reported a 28% decrease in their number of headache days (7 fewer days per month), compared with the placebo group, which reported just one fewer day per month. At 12 weeks, 53% of patients in the active group ranked their relief as excellent or good, compared with 17% in the placebo group. The study was presented at the 15th International Headache Congress, held during June 2011 in Berlin (Germany).

"Many migraine patients have exhausted all current treatment options and often are disabled by the pain and frequency of migraine attacks," said lead author Stephen Silberstein, MD, director of the Jefferson Headache Center (Philadelphia, PA, USA), and past president of the American Headache Society. "Achieving a reduction in the number of days they suffer from headache and a significant improvement in their quality of life may be even more important than pain reduction alone."

Migraine is a debilitating condition characterized by moderate to severe headaches, and is about three times more common in women than in men. The typical migraine headache is unilateral pain and pulsating in nature, lasting from 4 to 72 hours; symptoms include nausea, vomiting, photophobia, phonophobia, and is aggravated by routine activity. Approximately one-third of people who suffer from migraine headaches perceive an aura--unusual visual, olfactory, or other sensory experiences that are a sign that the migraine will soon occur.

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