From Concept to Reality: Implantable Devices for Migraine Treatment

Abstract

Migraine is a complex, chronic neurological disorder characterized by recurrent episodes of moderate to severe headache, often accompanied by nausea, photophobia, phonophobia, and sensory disturbances. The exact cause is not fully understood but is linked to abnormal brain activity involving nerve and chemical signals, and can be triggered by factors like stress, sleep disruption, and certain foods. Migraines can be managed through a combination of acute and preventive treatments, including lifestyle adjustments and medication, and often have a genetic component. The disorder has a multifactorial etiology involving genetic, hormonal, and environmental factors, and is more prevalent in females due to hormonal fluctuations during puberty, menstruation, pregnancy, and menopause. Implantable migraine devices include devices that stimulate nerves like the occipital nerve, sphenopalatine ganglion (SPG), or vagus nerve through implanted leads and a pulse generator. These are distinct from non-invasive devices like transcranial magnetic stimulation (TMS) or supraorbital nerve stimulation (SNS) which use handheld devices for stimulation without implantation. Implanted options are typically used for chronic or refractory migraines, while external devices may be used for acute or preventive treatment and often require a prescription. Overall, an integrated therapeutic strategy encompassing pharmacological, behavioral, and technological modalities can substantially improve patient outcomes and quality of life.