• Carlos M Ordás, María L Cuadrado, Juan A Pareja, Gonzalo de-Las-Casas-Cámara, Lidia Gómez-Vicente, Gustavo Torres-Gaona, Begoña Venegas-Pérez, Beatriz Álvarez-Mariño, Ana Diez Barrio, and Javier Pardo-Moreno.
• Department of Neurology, Hospital Rey Juan Carlos, Universidad Rey Juan Carlos, Móstoles, Madrid, Spain.
• Pain Med. 2020 Feb 1; 21 (2): 415-422.

Background And ObjectiveSuccessful preventive treatment in chronic migraine (CM) remains an unmet need in some cases, and new therapeutic strategies are emerging. We aimed to test the effect of noninvasive, transcutaneous supraorbital nerve stimulation (tSNS) in a group of patients with CM.Patients And MethodsThis was an open label, quasi-experimental design. Twenty-five CM patients were recruited from two hospital headache clinics. After a one-month baseline period, monthly visits were scheduled during three months. Headache occurrence, its intensity, and symptomatic medication intake were recorded through a diary kept by each patient. Both a per-protocol analysis and an intention-to-treat analysis were performed for the main outcome measures.ResultsTwenty-one and 24 patients were included in the per-protocol and the intention-to-treat analyses, respectively. In the per-protocol analysis, a significant four-day decrease in the mean monthly days with moderate or severe headache was observed from baseline to the end of the study (t test, P = 0.0163), and there was a nonsignificant reduction of 2.95 in the mean monthly total headache days. In the intention-to-treat analysis, a nonsignificant 3.37 reduction in the mean monthly days with moderate or severe headache was observed for the same period, and there was a significant 2.75 reduction in the mean monthly days with any headache (t test, P = 0.016).ConclusionstSNS could hold preventive properties in the treatment of CM, but the effect may be either mild or controversial. Double blind, sham-controlled studies are essential to confirm these findings and to outline their clinical relevance in the CM therapeutic scenario.© 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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