External stimulation of the trigeminal nerve for the prevention and acute treatment of episodic and chronic migraine

Stanak M, Wolf S, Jagos H
Record ID 32018000327
Authors' objectives: The aim of this systematic review was to investigate whether external trigeminal nerve stimulation (e-TNS), as a preventive or acute therapy, is more effective and safer than standard drug therapy or placebo with respect to improvement in migraine episodes, quality of life (QoL), satisfaction, and side effects.
Authors' results and conclusions: Given the small size of the highly selective sample of patients included in the evidence base (as compared to the large burden of disease that migraine creates), the conclusions about effectiveness and the positive safety profile appear to be inflated. The target population of e-TNS are not only patients refractory to medication, but mainly drug responsive patients, which makes replacing the use of medication a main objective of e-TNS.
Authors' recomendations: Larger controlled trials with best practice interventions (for prevention as well as acute treatment use of e-TNS) as comparators are necessary for potentially considering e-TNS to be part of the standard practice. The inclusion in the Austrian catalogue of benefits is currently not recommended.
Authors' methods: A systematic literature search was conducted in the following four databases: Medline via Ovid, Embase, The Cochrane Library, CRD (DARE, NHS-EED, HTA). The search was limited to prospective studies and articles published in English or German, but not to publication year. After deduplication, 433 citations remained for abstract screening. Seven further publications were found by hand search, resulting in 440 references overall. An additional search of clinical trial registries search yielded 70 results, of which seven proved relevant. The manufacturer provided no further publications.
Project Status: Completed
Year Published: 2018
URL for published report: http://eprints.aihta.at/1177/2/DSD_114.pdf
URL for additional information: http://eprints.aihta.at/1177/
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Migraine Disorders
  • Therapeutics
  • Electric Stimulation Therapy
  • Trigeminal Nerve
  • External stimulation
  • prevention
  • acute treatment
  • episodic migraine
  • chronic migraine
  • Cefaly
Organisation Name: Ludwig Boltzmann Institute for Health Technology Assessment
Contact Address: Ludwig Boltzmann Institute for fuer Health Technology Assessment (LBI-HTA), Garnisongasse 7/rechte Stiege Mezzanin (Top 20), 1090 Vienna, Austria. Tel: +43 1 236 8119 - 0 Fax: +43 1 236 8119 - 99
Contact Name: tarquin.mittermayr@aihta.at
Contact Email: office@aihta.at
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.