Neuromodulation and Neurostimulation Approaches for the Management of Migraine Pain

A frequent and often incapacitating neurological condition known as the migraine carries a heavy socioeconomic impact. Many patients find that the present pharmacological approach is unsatisfactory because the average response rate is below 50% and the majority of the most potent medications frequently generate unbearable adverse effects. Currently, ergot derivatives and triptans are considered specific treatments for preventing migraines, while analgesics and non-steroidal, anti-inflammatory medications are considered non-specific treatments. Although acute symptomatic medication can be improved, migraine is still a chronic illness that has the potential to worsen with time. Although there haven’t been many advancements in the field of migraine prevention recently, promising innovative treatments are being investigated, such as neuromodulatory approaches in drug-resistant migraine patients. The detection of various forms of neurostimulation for acute and preventive treatment was one of the most recent innovations in migraine neuromodulation. The fundamental notion behind this, is to stimulate the brain or peripheral and cranial nerve systems to lessen migraine frequency or pain. Understanding neuromodulation, its mechanism, its application in the treatment of migraine, and its various modalities with their own mechanisms of action and contraindications have been covered in this chapter. A variety of neurostimulation methods, e.g., remote electronic neuromodulation (REN), non-invasive vagal nerve stimulation (nVNS), external trigeminal nerve stimulation, (eTNS) and many others have been discussed.