Migraine Treatments

New Approaches to Treating Migraine

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New Approaches to Treating Migraine

If you have migraine, you’re likely aware that it’s complex, multi-dimensional…and inherited! Over 200 genetic shifts are believed responsible for making some individuals more vulnerable to migraine than others. And because every individual’s migraine profile is different, it would be challenging to find a true, one-size-fits-all treatment approach to manage it. 

But thanks to scientists and researchers, promising new developments are bringing improvement to people with migraine pain. Here are a few: 

Neuromodulation, a Non-Pharmacological Alternative to Migraine Treatment 

Non-pharmacological approaches are gaining popularity, as people with migraine have struggled to find the right medications for themselves or worried about over-medicating. The scientific and technological communities have collaborated to create safe yet effective, non-invasive devices for people with migraine.

Neuromodulation (or nerve stimulation) devices deliver electrical or magnetic pulses to specific nerves believed to play a role in migraine formation, with the goal of reducing migraine frequency and severity. Four types of devices currently approved by the Food and Drug Administration (FDA) are used to stimulate various critical nerves and pathways across the nervous system:

  • Supraorbital Stimulation (external trigeminal nerve stimulation, or e-TNS): These devices deliver micro-impulses that reach the upper branch of the trigeminal nerves, known to be involved in migraine formation. After a medical professional determines an appropriate level of stimulation, an individual who is mid-migraine, or who feels a migraine coming on, can simply place the device on their head to help relieve the pain. The device can be obtained over-the-counter at a pharmacy and used in the comfort of one’s own home. The two FDA-approved  e-TNS devices are Cefaly and Relivion
  • Vagus Nerve Stimulation: One of the longest nerves in the body, the vagus nerve extends from the base of the skull to the abdomen, helping to control several important bodily functions such as digestion, heart rate, and immunity. Vagus nerve stimulation (VNS) devices deliver small electrical currents at the side of the neck that help stimulate the parasympathetic nervous system (your body’s rest and digest mode) and bring pain relief during a migraine episode. Gammacore Sapphire is an example of an FDA-cleared handheld device designed to manage cluster headache and migraine symptoms. A prescription is required to obtain this product, and it is covered by some insurance plans. 
  • Remote Electrical Neuromodulation (REN): Rather than apply electrical impulses to the head area, the REN system stimulates the peripheral nerves in the upper arm. It aims to modulate the pain response by stimulating pain control centers in the brain stem, rather than the brain itself. A 2020 study reported that 74% of the participants who used REN for migraine pain felt relief within two hours; 36%, in fact, were completely pain-free. Additional studies are needed, but this is promising technology. Nerivio is an FDA-approved REN-based armband for treatment of acute migraine. Its accompanying app lets you keep a migraine diary, track your progress, and share data with your medical professional.

New Risk Variants for Migraine

An intensive 2022 study pooled genetic data from 873,000 research participants in the U.S., Europe, and Australia, 102,000 of whom had migraine disorder. It considered the two main migraine subtypes — migraine with aura (sensory disturbances) and without aura — and what makes them different at a molecular/genetic level. 

The study reported finding three risk variants for migraine with aura, two specific to migraine without area and, finally, nine new variants that increase migraine risk, regardless of subtype. 

Although the underlying mechanisms of migraine are still unknown, these new findings let scientists more confidently approach it as a neurovascular issue in origin, rather than just a neurological one. The findings also emphasize the importance of a holistic, individualized approach to developing treatment plans for people with migraine. 

The Gut-Brain Axis and Migraine 

A 2022 review provided a history of migraine theories and discussed researchers’ current understanding of how gut microbiota may be involved in the underlying mechanisms of migraine. 

This review looked not just at how the gut microbiota plays a role in migraine formation, but also at potential indirect factors, such as diet and probiotics, the vagus nerve, and so on. Overall, researchers found that certain microbiota changes were indeed powerful enough to change mood and pain tolerance. 

While migraine is typically characterized by the nature, frequency, and intensity of the headache, we now know that treatment of a migraine episode must encompass more than pain relief. Future models and clinical trials must focus on pinpointing microbiome changes that help to form and sustain a migraine; another path of study might determine how an altered gut microbiome affects the vagus nerve. 

In the treatment of migraine, scientists must observe other systems and mechanisms within the body, and consider psychosocial parameters as well. This compelling new paradigm will require much study, but can effectively spark new discoveries and advances in migraine relief. 

Are you ready to uncover the cause of your migraine episodes? One very effective approach is through a DNA-guided treatment program that gives you a clearer picture of why and how your migraines occur. DNA-informed treatments can help you find a tailored approach that works quickly to identify, treat, and potentially halt your migraines. 

Learn more by taking our quiz.

Sources
  1. EverydayHealth.com. Dunleavy, Brian P., et al. Nerve Stimulation Devices for Migraine Treatment. https://www.everydayhealth.com/migraine/guide/treatment/nerve-stimulation-devices/
  2. Frontiers. 1 Jan. 1AD. Marmura, Michael J., et al. Incorporating Remote Electrical Neuromodulation (Ren) into Usual Care Reduces Acute Migraine Medication Use: An Open-Label Extension Study. https://www.frontiersin.org/articles/10.3389/fneur.2020.00226/full
  3. ScienceDaily. Largest Genetic Study of Migraine to Date Reveals New Genetic Risk Factors. https://www.sciencedaily.com/releases/2022/02/220203122535.htm
  4. Nature News. Hautakangas, Heidi, et al. Genome-Wide Analysis of 102,084 Migraine Cases Identifies 123 Risk Loci and Subtype-Specific Risk Alleles. https://www.nature.com/articles/s41588-021-00990-0
  5. Neurobiology of Pain. Elsevier. Crawford, Joshua, et al. Gut Microbiota and Migraine. https://www.sciencedirect.com/science/article/pii/S2452073X22000071
  6. Mable Website. https://www.trymable.com
  7. Mable DNA Quiz. https://www.trymable.com/quiz/dna
  1. Cefaly. https://cdn.ziftrshop.com/m2ttulfels/cefaly-device-trans@2x.webp
  2. Relivion. https://www.relivion.com/wp-content/uploads/2022/08/relivion-device-circle-a.png
  3. Gammacore Sapphire. https://www.gammacore.com/wp-content/uploads/2022/01/gammacore-device-home.jpg
  4. Nerivio. https://nerivio.com/wp-content/uploads/2021/07/get-nerivio-img.png
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Updated on
September 23, 2022
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