American Board of Headache Management
CONGRATULATIONS to the American Board of Headache Management Awardees!
American Interventional Headache Society is offering American Board of Headache Management (ABHM) certification to qualified physicians. The AIHS Board has approved the board certification program which will enable physicians to document knowledge, training and skills in this new subspecialty 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 and practical exam.
Click Here For Important Dates On The Next Upcoming Headache Board Examination.
Calcitonin Gene Related Peptide (CGRP) in migraine pathophysiology
There is compelling evidence that CGRP plays an important role in migraine pathophysiology and thus representing an interesting target for therapeutic applications. Available research demonstrates that CGRP as well as other pro inflammatory mediators are being released from an activated trigeminal ganglion, which in turn leads to increase in further synthesis of CGRP. Elevated plasma concentration of CGRP during migraine headache attacks and CGRP level normalization or reduction with treatment has been established and is being discussed in this article.
Read more here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134175/
Principles of CGRP therapy in migraine
Migraine is one of the most prevalent and disabling conditions affecting more than 36 million people on the United States alone. Although there are number of FDA approved migraine preventative medications available the overall efficacy and tolerability are still not ideal. CGRP monoclonal antibodies is the first class of medications that were specifically developed to migraine prophylaxis. They bind to either CGRP receptor or CGRP ligand with great affinity and remarkable specificity and, unlike other therapeutic antibodies, do not alter immune system.
Read more here: https://onlinelibrary.wiley.com/doi/full/10.1111/head.13439
Safety and Efficacy of Cervical 10 kHz Spinal Cord Stimulation (SCS) for the Management of Refractory Chronic Migraine: A Prospective Study
This study was recently presented as an abstract at the North American Neuromodulation Society (NANS) meeting in January 2019.
From: The Pain and Neuromodulation Academic Research Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Sponsored by: Nevro Corp, Clinical Research, London, UK
Disclosure: HF SCS is not FDA approved for the treatment of migraine headaches.. This is an off-label indication.
Inclusion Criteria:
Age ≥18 years old
Chronic migraine with/without aura
Refractory to at least 3 preventive treatments
Exclusion Criteria:
•Medication overuse headache
•Severe depression (PhQ-9>19)
Implant Procedure
•Spinal Cord Stimulator (HF10)
•Leads positioned atC2
•No stimulation trial
Results:
18 patients completed the 54 weeks follow up period.
At base line 100% subjects had chronic migraine.
At 52 weeks; 45% of subjects returned to episodic migraine
At week 52; there was a 50% responder rate. Responders defined as at least 30% reduction in headache days per month post-device activation
Conclusion:
HF -SCS may offer a safe treatment option for patients with refractory chronic migraines. The results of this report justify the need for RCT.
