For those suffering from chronic headache and migraine, headache relief cannot come fast enough. Migraine pain is more than a simple headache. Migraine symptoms can be debilitating and include nausea, fatigue, sensitivity to sensory input, and visual disturbances like temporary blindness. While research into new migraine treatments has been sparse in recent years, there have been some promising new discoveries. Here are the most recent advances in headache relief.
Headache relief by more accurate injections
While botulinum toxin has been FDA-approved for use for headache relief since 2010, administering the actual injection has been a “hit or miss” proposition. New developments in the way that botulinum toxin is administered has changed all that with a tool called the MultiGuide.
The inventor is Dr. Daniel Bratbak, a doctor working at the neurosurgical department at St. Olav’s Hospital. Current technology uses something called BrainLab. This allows a surgeon performing an operation to see cross-sectional images. Researchers felt that these images needed to be less generalized and more tailored to precise tasks.
SINTEF researcher Christian Askeland points out that although BrainLab has served a useful purpose, it’s not quite enough for certain operations.
“BrainLab can be used for all types of operation, but here we’re talking about a very specific task involving accurate injection at a precise point by means of the insertion of a needle along a given path to a predefined migraine ‘centre’. This is why we need the benefits of a more tailored system.”
Dr. Bratbak further explained the problem of shifting attention at crucial moments to see what was happening on a screen:
“With the patient lying in front of me, I have to focus all my attention on guiding the tip of the needle to its target. If I have to shift my line of sight to get assistance from the screen display, my guidance of the needle is interrupted and I have to re-orient myself in order to continue.”
Dr. Bratbak solved that problem by mounting an iPhone on the MultiGuide system to integrate the needle positioning device with a clear view of where the needle should go for a more accurate injection. This can offer profound headache relief for sufferers for whom the botulinum toxin has not worked in the past.
Migraine surgery for teens promises headache relief
American Society of Plastic Surgeons (ASPS) member surgeon Bahman Guyuron, MD, emeritus professor of plastic surgery at Case School of Medicine, Cleveland, presented the findings of a study of migraine surgery for teens suffering from refractory chronic migraine.
Researchers developed new surgical techniques after noticing that some adults undergoing cosmetic forehead lifts found headache relief as a welcome side effect. Before the operation, trigger sites are identified using symptoms, nerve blocks, ultrasound Doppler, and CT scans.
Doctors recruited 14 patients under the age of 18 to participate in the study. The 11 females and three males achieved profound headache relief, including:
- Average frequency of headaches dropped from 25 per month to five per month post- operatively
- Pain level score decreased from 8.2 to 4.3 (out of ten)
- Five patients had no more headaches
- Average duration of headache decreased from 12 hours to four hours
Of all of the patients, only one had no change in frequency, but duration and intensity were both decreased.
Headache relief for adolescent migraine sufferers is often difficult to come by, and this new surgical technique offers hope for those in pain. This technique is especially useful for those patients who have not had success with other treatments.
An ounce of prevention
Migraine drugs generally fall into two categories: those that help prevent migraines and those that offer headache relief when the pain hits. For the first time in many years, researchers have developed a new drug that aims to prevent migraines before they begin.
Peter J. Goadsby, MD, PhD, chair of the scientific program of the American Headache Society’s annual scientific meeting and chief of the UCSF Headache Center, is one of the world’s leading headache treatment experts and researchers. He notes that it’s time to focus on prevention and that there has not been a new migraine medication since 1991 (triptans that treat migraines instead of preventing them).
Dr. Goadsby noted that new preventative measures were overdue, saying:
“This development is a transformative moment in migraine treatment. There’s no question that we need something better. In fact, for prevention we really need something designed specifically for migraine.”
Dr. Goadsby pointed to the work of four pharmaceutical companies targeting calcitonin gene-related peptide (CGRP), one of the key factors of migraine pain. Anti-CGRP therapies are showing great promise in headache relief and are moving into phase III trials with human subjects.
“The potential of these new compounds is enormous and gives us real hope that effective specific treatments for migraine may be on the near horizon. The development of CGRP antibodies offers the simple, yet elegant and long awaited option for migraine patients to finally be treated with migraine preventives; it’s a truly landmark development.”
Migraines affect approximately 36 million people in the U.S., more than asthma and diabetes combined. Four million of those people experience high-frequency migraines at a rate of 15 or more per month.
While those who don’t suffer from migraine pain may struggle to understand why new treatments are so vital, putting it into financial terms alone may help. Migraine pain in the U.S. costs approximately $20 billion dollars annually in direct costs (e.g., doctor’s visits and medications) and indirect costs (i.e., missed days at work and disability payments).
In both human and capital terms, headache relief is an important research focus. Which of these three new developments are most promising to you?