Role of Trans-cutaneous Electrical Nerve Stimulation in chronic migraine prophylaxis

Abstract

Chronic migraine (CM) is a complex, progressive headache disorder affecting approximately 0.9-2.2% of the general adult population (Burstein et al., 2015). CM is associated with significant disability, reduced health-related quality of life (HRQoL), and considerable healthcare cost (Dodick et al., 2010). Few preventative treatments for CM have been investigated. The effectiveness of both acute migraine treatments and prophylactic medications may be further complicated by frequent overuse of acute headache pain medication (eg, simple analgesics, triptans, opioids, ergots) by this patient population.So alternative therapies are therefore warranted (Dodick et al., 2010). One of these alternatives is transcutaneous electrical nerve stimulation (TENS) as a neurostimulation tool with the ability to send afferent input to CNS to activate descending pain inhibitory systems to reduce hyperalgesia. TENS showed positive results when used in migraine treatment but more studies still need to be conducted to evaluate efficacy and mode of action of TENS in migraine treatment(Vance et al., 2014). Our double blinded sham controlled study examined the efficacy of 6 sessions of active TENS therapy applied to tender points related to supraorbital and/or greater occipital nerve versus sham stimulation in improving headache frequency, headache severity, headache index, abortive