Beyond Pills: Your Guide to Drug-Free Neuromodulation for Migraine

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Key Questions

• How is neuromodulation used to treat the symptoms of migraine disease?
• Can neuromodulation prevent as well as treat migraine attacks?
• Do health insurance providers in the U.S. generally cover the costs of these devices?
• Are neuromodulation devices challenging for patients to use?
• Which devices are cleared for children or adolescents?
• Are these devices safe for use while a person is pregnant or breastfeeding?
• Who should avoid these devices for safety reasons?
• When should a clinician consider recommending neuromodulation as a treatment?
• What kind of results can patients expect?
• If one neuromodulation device isn’t effective, should a patient try a different one?

Interview Notes

• Stewart Tepper, MD, FAHS
• Stewart J. Tepper, MD|Geisel School of Medicine at Dartmouth
• American Headache Society
• American Migraine Foundation
• Study: “Neuromodulation in trigeminal autonomic cephalalgias: 11-year experience of non-invasive vagus nerve stimulation”
• Study: “Safety of remote electrical neuromodulation for acute migraine treatment in pregnant women: A retrospective controlled survey‐study”
• Professional guidelines: “The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice”
• Press release: “Theranica Announces U.S. Coverage for Nerivio® Reaching ~130 Million Lives, Attaining Payer Scale Comparable to Leading Migraine Drugs”
• Ongoing study: NCT04994509 | Pre-Exposure Prophylaxis Study of Lenacapavir and Emtricitabine/Tenofovir Alafenamide in Adolescent Girls and Young Women at Risk of HIV Infection | ClinicalTrials.gov
• Ongoing study: NCT06167655 | A Pivotal Study Evaluating Safety And Efficacy Of The Shiratronics Migraine Therapy System | ClinicalTrials.gov

Treatments Mentioned

• CEFALY
• CGRP monoclonal antibodies (mAbs)
• gammaCore
• HeadaTerm 2
• Nerivio
• Neuromodulation devices
• Occipital nerve implantable stimulators
• Relivion
• SAVI Dual (sTMS by eNeura)
• TENS (transcutaneous electrical nerve stimulation) units
• Truvaga

For Additional Links and Resources, click here.

Disclaimer: The Migraine World Summit aims to bring you a variety of perspectives and expertise, free from bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.

Expert

Stewart Tepper, MD, FAHS

Vice President
The New England Institute for Neurology and Headache