Percutaneous Bioelectric Current Stimulation for Chronic Cluster Headache – A Possible Transformative Approach to Cluster Headache
Authors Molsberger A, McCaig CD
Received 13 December 2019
Accepted for publication 11 March 2020
Published 23 April 2020 Volume 2020:13 Pages 817—828
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Michael E Schatman
Albrecht Molsberger,1 Colin D McCaig2
1Department of Orthopedics, Ruhr-University Bochum, Germany, Clinic for Headache, Pain and Locomotive Disorders, Duesseldorf, Germany; 2Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, Scotland
Correspondence: Albrecht Molsberger
Fax +49 211 86688 18
Background: Cluster headache (CH) is considered to be a catastrophic disease presenting the most severe human pain condition. Available pharmacological treatments are hampered by unwanted side effects, and there is an urgent need for non-pharmacological treatment alternatives. We present a novel therapeutic approach for chronic CH, having evolved from an episodic CH, using a non-invasive percutaneous bioelectric current stimulation (PBCS), which generates static electric fields in the range of the naturally occurring electric potentials.
Patients and Methods: This study employed a retrospective data analysis of 20 cases of chronic cluster headache (CCH) patients, four of those having had cluster-related surgery (SPG, ONS). All patients were treated with PBCS between 2014 and 2018. Data of these patients were analyzed with respect to frequency of CH attacks and triptan application and followed up for one (20 cases) or two (12 cases) years.
Results: Four weeks after the first PBCS treatment, cluster headache attacks were reduced from 2.8 to 1.7 per day and triptan application decreased from 2.5 to 1.5 times/day. Six non-responders, 4 of which had pre-CH surgery, did not show any reaction to PBCS, while 14 responders improved within 4 weeks from 2.2 to 0.7 attacks/day and 2.0 to 0.4 triptan applications/day. A 50% or greater reduction of attack frequency was observed in 10 patients after 4 weeks and in 11 patients after 12 weeks. One year after the first treatment, 13/20 patients experienced a reduction of attack frequency of 50% or more, while remarkably 10 patients were completely free of attack. After 2 years, 8 of 12 patients experienced a reduction of attack frequency of 50% or more and 7 of those were completely symptom-free. No serious adverse effects were observed.
Conclusion: PBCS is a promising transformative treatment approach for CCH patients. Drug consumption was reduced significantly, and the CCH may revert back to an episodic cluster headache with increasingly long times of remission. Responders can be clearly differentiated from non-responders. The data support the need for randomized controlled trials.
Keywords: chronic cluster headache, bioelectric current, pain, direct current
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