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The Next Frontier For Headaches Managment
Author: Ghassan Haddad
Publisher: Haddad Ghassan
5 pages
One time payment: €12.40
Required subscription: Academic
Type of publication: Article
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                           The next frontier of headache pain management




Cluster headache (CH) is a neurological disorder characterized by recurrent, severe headaches on one side of the head, typically around the eye. There are often accompanying autonomic symptoms during the headache such as eye watering, nasal congestion and swelling around the eye, typically confined to the side of the head with the pain.

Cluster headache belongs to a group of primary headache disorders, classified as the trigeminal autonomic cephalalgias or (TACs). Cluster headache is named after the demonstrated grouping of headache attacks occurring together (cluster).


 Individuals typically experience repeated attacks of excruciatingly severe unilateral headache pain. Cluster headache attacks often occur periodically; spontaneous remissions may interrupt active periods of pain.

 The cause of cluster headache has not been identified.

While there is no known cure, cluster headaches can sometimes be prevented and acute attacks treated by this new therapy called GammaCore:

GammaCore is a novel, non-invasive vagus nerve stimulation (nVNS) delivered by a patient friendly, hand-held device



             Figure 1







A completely non-invasive therapy stimulates the cervical branch of the vagus nerve. No surgery. No invasive procedure

GammaCore demonstrates the ability to suppress high glutamate levels in the trigeminal nucleaus caudalis (TNC), which may be the pain-blocking mechanism of nVNS

GammaCore avoids the surgery-related adverse effects and costs of implantable neuromodulating devices and potentially limits adverse effects related to continuous on-off stimulation.

GammaCore is administered with a hand-held device, about the size of a mobile phone that generates a unique electrical signal. A conductive gel is applied on the stimulation surfaces of the device and it is placed on the neck. Each dose takes approximately 2 minutes to administer (patients may require more than one dose per treatment).


According to the latest publication in the Headache Journal Volume 56, Issue 8
September 2016 Pages 1317–1332

In subjects with episodic cluster headaches, GammaCore therapy offered significant and clinically meaningful benefits over sham treatment, including rapid (within 15 minutes) and sustained (through 60 minutes) pain relief.


 GammaCore device was also safe and well tolerated and thus represents a novel acute treatment option with a positive risk-benefit profile for patients with episodic cluster headaches.

 A report of a similar large, randomized, sham-controlled trial completed in Europe is forthcoming and may validate the results seen in this study.


Edited by Dr Ghassan George Haddad

American Board of Psychiatrty and Neurology

















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