Therapeutic strategies that act on the peripheral nervous system in primary headache disorders

J. Tajti, Délia Szok, Aliz Nyári, L. Vécsei

Research output: Contribution to journalArticle

Abstract

Introduction: Acute and preventive treatment of primary headache disorders is not completely resolved with regard to efficacy, safety, and tolerability. Hence, peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Areas covered: A PubMed search of papers published from January 2012 to October 2018 was conducted. The goal of this review was to analyze the efficacy and safety of invasive (implantable) peripheral neurostimulation methods (the occipital nerve, the cervical branch of vagal nerve, the sphenopalatine ganglion) and non-invasive (transcutaneous) peripheral neurostimulation methods (the occipital nerve, the supraorbital nerve, and the cervical and auricular branches of the vagal nerve), based on the results of published clinical trials and case series. Acting also on the peripheral nervous system, peripheral nerve (i.e. greater occipital nerve) and ganglion (i.e. sphenopalatine ganglion) blockades, botulinum neurotoxin type A-hemagglutinin complex therapies, and calcitonin gene-related peptide-related monoclonal antibody treatments in this patient population are also discussed. Expert opinion: This review summarizes the latest results on the therapeutic strategies acting on the periphery in primary headache disorders. These therapeutic options are minimally invasive or non-invasive, efficacious, safe, and well tolerated.

Original languageEnglish
Pages (from-to)509-533
Number of pages25
JournalExpert review of neurotherapeutics
Volume19
Issue number6
DOIs
Publication statusPublished - Jun 1 2019

Fingerprint

Primary Headache Disorders
Peripheral Nervous System
Ganglia
Therapeutics
Safety
Type A Botulinum Toxins
Calcitonin Gene-Related Peptide
Nerve Block
Expert Testimony
Hemagglutinins
Peripheral Nerves
PubMed
Monoclonal Antibodies
Clinical Trials
Pharmaceutical Preparations
Population

Keywords

  • Botulinum neurotoxin type A-hemagglutinin complex
  • calcitonin gene-related peptide
  • cluster headache
  • drug-resistant
  • ganglion blockade
  • migraine
  • monoclonal antibodies
  • nerve blockade
  • peripheral neurostimulation
  • treatment

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Therapeutic strategies that act on the peripheral nervous system in primary headache disorders. / Tajti, J.; Szok, Délia; Nyári, Aliz; Vécsei, L.

In: Expert review of neurotherapeutics, Vol. 19, No. 6, 01.06.2019, p. 509-533.

Research output: Contribution to journalArticle

@article{a36f08d8d154455d8d841f80a3d5e23a,
title = "Therapeutic strategies that act on the peripheral nervous system in primary headache disorders",
abstract = "Introduction: Acute and preventive treatment of primary headache disorders is not completely resolved with regard to efficacy, safety, and tolerability. Hence, peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Areas covered: A PubMed search of papers published from January 2012 to October 2018 was conducted. The goal of this review was to analyze the efficacy and safety of invasive (implantable) peripheral neurostimulation methods (the occipital nerve, the cervical branch of vagal nerve, the sphenopalatine ganglion) and non-invasive (transcutaneous) peripheral neurostimulation methods (the occipital nerve, the supraorbital nerve, and the cervical and auricular branches of the vagal nerve), based on the results of published clinical trials and case series. Acting also on the peripheral nervous system, peripheral nerve (i.e. greater occipital nerve) and ganglion (i.e. sphenopalatine ganglion) blockades, botulinum neurotoxin type A-hemagglutinin complex therapies, and calcitonin gene-related peptide-related monoclonal antibody treatments in this patient population are also discussed. Expert opinion: This review summarizes the latest results on the therapeutic strategies acting on the periphery in primary headache disorders. These therapeutic options are minimally invasive or non-invasive, efficacious, safe, and well tolerated.",
keywords = "Botulinum neurotoxin type A-hemagglutinin complex, calcitonin gene-related peptide, cluster headache, drug-resistant, ganglion blockade, migraine, monoclonal antibodies, nerve blockade, peripheral neurostimulation, treatment",
author = "J. Tajti and D{\'e}lia Szok and Aliz Ny{\'a}ri and L. V{\'e}csei",
year = "2019",
month = "6",
day = "1",
doi = "10.1080/14737175.2019.1615447",
language = "English",
volume = "19",
pages = "509--533",
journal = "Expert Review of Neurotherapeutics",
issn = "1473-7175",
publisher = "Expert Reviews Ltd.",
number = "6",

}

TY - JOUR

T1 - Therapeutic strategies that act on the peripheral nervous system in primary headache disorders

AU - Tajti, J.

AU - Szok, Délia

AU - Nyári, Aliz

AU - Vécsei, L.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Introduction: Acute and preventive treatment of primary headache disorders is not completely resolved with regard to efficacy, safety, and tolerability. Hence, peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Areas covered: A PubMed search of papers published from January 2012 to October 2018 was conducted. The goal of this review was to analyze the efficacy and safety of invasive (implantable) peripheral neurostimulation methods (the occipital nerve, the cervical branch of vagal nerve, the sphenopalatine ganglion) and non-invasive (transcutaneous) peripheral neurostimulation methods (the occipital nerve, the supraorbital nerve, and the cervical and auricular branches of the vagal nerve), based on the results of published clinical trials and case series. Acting also on the peripheral nervous system, peripheral nerve (i.e. greater occipital nerve) and ganglion (i.e. sphenopalatine ganglion) blockades, botulinum neurotoxin type A-hemagglutinin complex therapies, and calcitonin gene-related peptide-related monoclonal antibody treatments in this patient population are also discussed. Expert opinion: This review summarizes the latest results on the therapeutic strategies acting on the periphery in primary headache disorders. These therapeutic options are minimally invasive or non-invasive, efficacious, safe, and well tolerated.

AB - Introduction: Acute and preventive treatment of primary headache disorders is not completely resolved with regard to efficacy, safety, and tolerability. Hence, peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Areas covered: A PubMed search of papers published from January 2012 to October 2018 was conducted. The goal of this review was to analyze the efficacy and safety of invasive (implantable) peripheral neurostimulation methods (the occipital nerve, the cervical branch of vagal nerve, the sphenopalatine ganglion) and non-invasive (transcutaneous) peripheral neurostimulation methods (the occipital nerve, the supraorbital nerve, and the cervical and auricular branches of the vagal nerve), based on the results of published clinical trials and case series. Acting also on the peripheral nervous system, peripheral nerve (i.e. greater occipital nerve) and ganglion (i.e. sphenopalatine ganglion) blockades, botulinum neurotoxin type A-hemagglutinin complex therapies, and calcitonin gene-related peptide-related monoclonal antibody treatments in this patient population are also discussed. Expert opinion: This review summarizes the latest results on the therapeutic strategies acting on the periphery in primary headache disorders. These therapeutic options are minimally invasive or non-invasive, efficacious, safe, and well tolerated.

KW - Botulinum neurotoxin type A-hemagglutinin complex

KW - calcitonin gene-related peptide

KW - cluster headache

KW - drug-resistant

KW - ganglion blockade

KW - migraine

KW - monoclonal antibodies

KW - nerve blockade

KW - peripheral neurostimulation

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85067214686&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067214686&partnerID=8YFLogxK

U2 - 10.1080/14737175.2019.1615447

DO - 10.1080/14737175.2019.1615447

M3 - Article

C2 - 31053055

AN - SCOPUS:85067214686

VL - 19

SP - 509

EP - 533

JO - Expert Review of Neurotherapeutics

JF - Expert Review of Neurotherapeutics

SN - 1473-7175

IS - 6

ER -