Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?
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Sphenopalatine ganglion neuromodulation in migraine : What is the rationale? / Khan, Sabrina; Schoenen, Jean; Ashina, Messoud.
I: Cephalalgia : an international journal of headache, Bind 34, Nr. 5, 04.2014, s. 382-391.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Sphenopalatine ganglion neuromodulation in migraine
T2 - What is the rationale?
AU - Khan, Sabrina
AU - Schoenen, Jean
AU - Ashina, Messoud
PY - 2014/4
Y1 - 2014/4
N2 - OBJECTIVE: The objective of this article is to review the prospect of treating migraine with sphenopalatine ganglion (SPG) neurostimulation.BACKGROUND: Fuelled by preliminary studies showing a beneficial effect in cluster headache patients, the potential of treating migraine with neurostimulation has gained increasing interest within recent years, as current treatment strategies often fail to provide adequate relief from this debilitating headache. Common migraine symptoms include lacrimation, nasal congestion, and conjunctival injection, all parasympathetic manifestations. In addition, studies have suggested that parasympathetic activity may also contribute to the pain of migraineurs. The SPG is the largest extracranial parasympathetic ganglion of the head, innervating the meninges, lacrimal gland, nasal mucosa, and conjunctiva, all structures involved in migraine with cephalic autonomic symptoms.CONCLUSION: We propose two possible mechanisms of action: 1) interrupting the post-ganglionic parasympathetic outflow to inhibit the pain and cephalic autonomic symptoms, and 2) modulating the sensory processing in the trigeminal nucleus caudalis. To further explore SPG stimulation in migraineurs as regards therapeutic potential and mode of action, randomized clinical trials are warranted.
AB - OBJECTIVE: The objective of this article is to review the prospect of treating migraine with sphenopalatine ganglion (SPG) neurostimulation.BACKGROUND: Fuelled by preliminary studies showing a beneficial effect in cluster headache patients, the potential of treating migraine with neurostimulation has gained increasing interest within recent years, as current treatment strategies often fail to provide adequate relief from this debilitating headache. Common migraine symptoms include lacrimation, nasal congestion, and conjunctival injection, all parasympathetic manifestations. In addition, studies have suggested that parasympathetic activity may also contribute to the pain of migraineurs. The SPG is the largest extracranial parasympathetic ganglion of the head, innervating the meninges, lacrimal gland, nasal mucosa, and conjunctiva, all structures involved in migraine with cephalic autonomic symptoms.CONCLUSION: We propose two possible mechanisms of action: 1) interrupting the post-ganglionic parasympathetic outflow to inhibit the pain and cephalic autonomic symptoms, and 2) modulating the sensory processing in the trigeminal nucleus caudalis. To further explore SPG stimulation in migraineurs as regards therapeutic potential and mode of action, randomized clinical trials are warranted.
KW - Electric Stimulation Therapy
KW - Humans
KW - Implantable Neurostimulators
KW - Migraine Disorders
KW - Pterygopalatine Fossa
U2 - 10.1177/0333102413512032
DO - 10.1177/0333102413512032
M3 - Journal article
C2 - 24293088
VL - 34
SP - 382
EP - 391
JO - Cephalalgia
JF - Cephalalgia
SN - 0800-1952
IS - 5
ER -
ID: 138778720