Non-invasive Vagus Nerve Stimulation in Migraine Therapy: A New Hope

Introduction

The vagus nerve is one of the 12 cranial nerves that start from a part of the brain. It helps regulate your heart rate, digestion, respiratory rate, immune system, etc. It is like a bridge between the brain and the peripheral nervous system. It is believed that migraine headaches can be relieved by activating the vagus nerve. Curious? Let's see how.

What Is Neuromodulation for Migraines?

Nerves are present throughout our body. In the neuromodulation process, doctors stimulate these nerves. Electrical, mechanical, or magnetic things can excite our nerves, which are present either centrally or peripherally in our body. You might wonder how neuromodulation can help regulate pain signals in migraine. For this, you have to dive deep into the migraine. In migraines, the pain follows specific paths that carry signals to our brains. In neuromodulation, the stimuli block these paths. As a result, you feel little or no pain.

Nerve stimulation for migraine is becoming very popular among patients due to its simplicity. As it's a non-invasive process, no cut or surgery is required. Also, a lot of patients do not like lifelong medicines for migraine due to their side effects. In such cases, neuromodulation is very effective. Moreover, if you can not take medication due to various medical reasons, neuromodulation is the best-suited treatment for you.

How Does Non-invasive Vagus Nerve Stimulation Help in Migraine?

The vagus nerve is present on both sides of your body and connects the brain and abdomen. This nerve manages pain. Any issues in this nerve can trigger migraine pain. As a result,migraine and the vagus nerve have a close relationship.

Vagus nerve stimulation (nVNS) is a type of neuromodulation or therapy that modifies nerve functioning. It involves using a device that stimulates the vagus nerve in the neck to deliver modest electrical pulses to the brain stem regularly. The electrical charge can change the function of brain cells in various parts of the brain. This is like a heart pacemaker and is called a brain pacemaker. When other treatments fail, doctors try nVNS as a treatment.

Because of innovations in VNS technology, more convenient, non-invasive therapies are now possible. Currently, migraines and cluster headaches are treated with these noninvasive methods. The handheld VNS device sends electrical pulses via the skin. At home, users hold the gadget against their necks to utilize it.

The machine sends tiny electrical pulses into the skin, targeting the vagus nerve for two minutes during each therapy session. It can be used to stop migraine attacks before they start, help stop pain signals, and lessen migraine symptoms.

Is the VNS Device for Migraine FDA-Approved?

The VNS device has FDA (Food and Drug Administration) clearance for the treatment and prevention of migraine in adults and adolescents over the age of twelve. Additionally, it has been approved by the FDA for the management and avoidance of adult cluster headaches. It is critical to realize that many medical devices have FDA clearance but not FDA approval. This has to do with American regulations surrounding devices.

Only class III medical devices, such as pacemakers and insulin pumps, that pose a serious risk to a person's health need FDA approval. Usually, gadgets that resemble existing equipment with a verified safety record are cleared for use rather than authorized.

How Is Vagus Nerve Stimulation Beneficial for Migraine?

For individuals who experience frequent migraine attacks and do not want to use excessive amounts of as-needed drugs (such as abortives), which might lead to medication-overuse headaches, this neuromodulation device is the best option. Although there is a maximum number of times a patient can use the VNS device, the number is so large that it is doubtful that any patient will use the device more than once a day, making it safe to use numerous times.

Moreover, the VNS device is non-invasive, which significantly lowers the risk of side effects like infection from surgery. There are also no notable adverse effects linked to the device.

What Are the Risks of VNS Devices?

People with heart issues may not be able to use VNS safely because it can alter cardiac rhythm.

VNS Devices should not be used in conjunction with other portable devices, such as muscle stimulators, or by those who have implanted medical devices, such as pacemakers or hearing aids. Studies have shown that non-invasive VNS is a safe alternative to migraine drugs. However, doctors are not sure how safe it is for young and pregnant women.

Devices that stimulate the vagus nerve may have the following negative effects:

• Lightheadedness.

• Pain and uneasiness in the head and forehead due to the application of the machine.

• Irritation and redness in those areas.

What Are Non-vagus Nerve Stimulation Therapies for Migraines?

Recently, scientists have discovered that the vagus nerve is not the only nerve involved in migraines. Migraine is a complex disease where other nerves are also involved. These nerves are present all over our head and neck region. Vagus nerve stimuli can not cure non-vagus nerve headaches. Moreover, doctors can not use nVNS in pregnant patients or patients who have heart issues. Also, if you have a pacemaker or cochlear implants, you are not suitable for nVNS. That is why other non-vagus nerve stimulation processes are gaining popularity.

1. Transcranial Magnetic Stimulation (TMS): Here, the doctor will ask you to wear a device on your head or scalp. This wearable device produces magnetic pulses that create electrical impulses within your brain. These impulses reduce the hyperexcitability of the cortex (a state of excitement) of the brain. Also, these stimuli can maintain the level of various chemicals in the brain, like glutamate and dopamine. The FDA has approved this device and advises its use for patients over twelve years old. If you are suffering from acute migraine, this device is not suitable for you.

2. External Trigeminal Nerve Stimulation (eTNS): In transcranial magnetic stimulation (TMS), electromagnetic pulses or waves are used to stimulate the nerve cells in the brain. This technique targets the outer layer of the brain. The magnetic fields generate a mild electrical current that activates specific nerves, which can help reduce the likelihood of experiencing a migraine. The FDA has permitted one TMS device for home use aimed at preventing migraines, referred to as sTMS (single-pulse TMS).

3. Occipital Nerve Stimulation (ONS): In this process, electrical stimuli are given to you at the back of the neck. This treatment is not only useful for chronic migraine cases but also can be used in various headaches and trigeminal neuralgia (a type of nerve pain).

4. Supraorbital Nerve Stimulation (SNS): Stimulating the supraorbital nerve can produce a quick calming effect in healthy people. This affects the central and peripheral function of the trigeminal system. Such an act activates the supraorbital nerve and blocks the pain via the trigeminal nerve.

What Are Other Treatment Options for Migraine?

Additional migraine treatments:

• Sleep in a dark place with your eyes closed.

• Apply a cold cloth or ice to the forehead.

• Take enough water.

• During the early stages of a migraine, acute treatments, such as Triptans and nonsteroidal anti-inflammatory drugs (NSAIDs), relieve pain as soon as symptoms appear.

• Preventive treatments, such as beta-blockers and antidepressant supplements, such as vitamin B2, coenzyme Q10, butterbur, relaxation training, biofeedback, and lifestyle modifications, such as regular exercise and regular sleep, help in avoiding migraine triggers.

When to Consult a Physician?

If someone wants to attempt VNS for a migraine, they can consult a physician. The doctor can verify whether it is the right course of treatment for them.

If someone has received VNS and encounters any of the following symptoms, they should get in touch with a doctor right away:

• A persistently raspy voice.

• VNS hurts; it interferes with swallowing and breathing or can cause choking.

• Any new or worrying changes related to utilizing VNS, such as an increase in sleepiness, other changes in consciousness, or a change in heart rate.

• If a VNS device malfunctions or stops functioning, users can also consult a physician.

Conclusion

Migraine is something we do not like at all. All of us want a migraine-free life where we do not need to take medicines. That is why non-invasive vagus nerve stimulation is a promising option for us. This can regulate neurotransmitter release and nerve pathways. If we take VNS, we do not need to take medicines; it can free us from migraine. Also, people who can not take the common treatment option can use this safely. We can use it at home easily. However, scientists are still working on it to make it more useful.

Key Takeaway From iCliniq:

Nowadays, doctors are trying different things to treat migraines. As they want their patients to be free from medicines, they are using unique things like non-invasive vagus nerve stimulation. This modern process can free you from regular drugs. Also, you can easily use it at home. However, you should talk to your doctor before starting anything. For more information, visit icliniq.com.