AIHS Press Release and Newsletter - April 2016

American Board of Headache Management

AIHS will offer the new American Board of Headache Management (ABHM) to qualified physicians beginning in Spring 2017.
The AIHS Board recently approved the board certification program which will enable physicians to document knowledge, training and skills in this new subspeciality of pain management. This board certificate program, will require candidates to provide evidence of prior training and experience, and successfully complete a written as well as an oral/practical exam.

Neuromodulation for headache management

FDA has approved the Transcranial Magnetic Stimulator (TMS) for acute treatment of migraine as well as Transcutaneous Suprorbital Neurostimation (tSNS) for prevention of migraine (AKA CEFALY). The way TMS works is not entirely clear but it most likely disrupts the cortical spreading depression.

CEFALY has been best studied for prevention of migraine and modulates the supraorbital nerves.

There are other devices that are being investigated and hence not FDA approved yet. These include the non-invasive vagal nerve stimulator (nVNS), the non-invasive caloric thermoneurmodulation (TNM), the Sphenopalatine ganglion stimulation (SPG), Occipital nerve stimulation (ONS), and Deep Brain Stimulation (DBS).
Most recent review article summarizes further more in detail about the above mentioned neuromodulatory devices.

Read more here: http://painmedicine.oxfordjournals.org/ content/16/9/1827 (http://painmedicine.oxfordjournals.org/ content/16/9/1827 )

Possible mechanisms of action of non-invasive vagus nerve stimulation

Non-invasive vagus nerve stimulation (nVNS) is an exciting new therapy that is currently in clinical trials for the treatment of cluster and migraine headache. Headache may in part be treated by nVNS

through anti-inflammatory mechanisms. This placebo-controlled study was carried out to test transcutaneous nVNS with the newly developed (gammaCore) device to determine if it modulates the peripheral immune system. As a result, nVNS group demonstrated greater decrease in IL-8 concentration (p < 0.05), as well as cytokine interleukin 1β, tumor necrosis factor, and chemokine, macrophage inflammatory protein, and monocyte chemoattractant protein levels compared to the sham group.

Taken together, nVNS downregulates inflammatory cytokine release that suggests nVNS may be an effective anti-inflammatory mediated headache treatment.

Read more here: http://onlinelibrary.wiley.com/doi/10.1111/