Paul Durham, PhD: Noninvasive Vagus Nerve Stimulation’s Novel Mechanism in Migraine

At the 2019 American Headache Society Annual Meeting, July 11-14, in Philadelphia, Pennsylvania, Paul Durham, PhD, and colleagues presented data showing that noninvasive vagus nerve stimulation could be as effective as triptan therapy in the relief of episodic migraine. However, the work also identified that this method of stimulation may be working through a novel mechanism of action.

NeurologyLive sat with Durham to find out more about the study’s findings and how this intervention differs from what’s currently available to patients. He explained that the team injected complete Freund’s adjuvant (CFA) at 10 rat neck muscle sites to induce inflammation in the model, and then exposed them to either the aroma of California bay leaf oil extract or sodium nitroprusside. Either stimulation administered in 1 ms pulses at 5 kHz, repeated at 25 Hz for 2 minutes at a pair of 5-minute intervals, or sumatriptan delivered subcutaneously at a dose of 0.3 mg/kg.

Noninvasive vagus nerve stimulation was approved by the FDA in January 2018, based on data from the PRESTO trial (NCT02686034), which showed consistent and significantly better pain relief at both 30 and 60 minutes (P .03). Additionally, it showed a decrease of pain intensity at 30, 60, and 90 minutes, as well as a reduction in rescue medicine.