scholarly journals Greater Occipital Nerve Stimulation via the Bion® Microstimulator: Implantation Technique and Stimulation Parameters Clinical Trial: NCT00205894

2009 ◽  
Vol 3;12 (3;5) ◽  
pp. 621-628 ◽  
Author(s):  
Terrence L. Trentman
Keyword(s):  
Nerve Stimulation ◽  
Primary Headache ◽  
Implantation Technique ◽  
Headache Disorders ◽  
Occipital Nerve ◽  
Primary Headache Disorders ◽  
Stimulation Parameters ◽  
Greater Occipital Nerve ◽  
The Mean ◽  
One Year

Background: Millions of patients suffer from medically refractory and disabling primary headache disorders. This problem has led to a search for new and innovative treatment modalities, including neuromodulation of the occipital nerves. Objectives: The primary aim of this study is to describe an implantation technique for the Bion® microstimulator and document stimulation parameters and stimulation maps after Bion placement adjacent to the greater occipital nerve. The secondary aim is to document outcome measures one year post-implant. Design: Prospective, observational feasibility study. Methods: Nine patients with medically refractory primary headache disorders participated in this study. Approximately 6 months after Bion insertion, stimulation parameters and maps were documented for all patients. At one year, outcome measures were collected including the Migraine Disability Assessment Score. Results: At 6 months, the mean perception threshold was 0.47 mA, while the mean discomfort threshold was 6.8 mA (stimulation range 0.47 – 6.8 mA). The mean paresthesia threshold was 1.64 mA and the mean usage range was 16.0. There were no major complications reported such as device migration, infection, or erosion. One patient stopped using her Bion before the 12-month follow-up visit. At one year, 7 of the 8 patients were judged as having obtained fair or better results in terms of reduction of disability; 5 patients had greater than a 90% reduction in disability. Limitations: Small, heterogeneous patient population without control group. Not blinded or randomized. Conclusion: The Bion can be successfully inserted adjacent to the greater occipital nerve in an effort to treat refractory primary headache disorders. This microstimulator may provide effective occipital stimulation and headache control while minimizing the risks associated with percutaneous or paddle leads implanted subcutaneously in the occipital region. Key words: Chronic headache, migraine, cluster headache, peripheral nerve stimulation

Long-Term Outcome in Occipital Nerve Stimulation Patients With Medically Intractable Primary Headache Disorders

2012 ◽  
Vol 16 (6) ◽  
pp. 557-564 ◽  
Author(s):  
Ann Chang Brewer ◽  
Terrence L. Trentman ◽  
Michael G. Ivancic ◽  
Bert B. Vargas ◽  
Alanna M. Rebecca ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Primary Headache ◽  
Headache Disorders ◽  
Occipital Nerve Stimulation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Occipital Nerve ◽  
Primary Headache Disorders

scholarly journals Prevalence of Primary Headache Disorders among Information Technology Staff in China: The Negative Effects of Computer Use and Other Correlative Factors

2020 ◽  
Author(s):  
Chunlin Li ◽  
Lei Zhang ◽  
Jin Zhou ◽  
zhiliang Fan ◽  
Yan Wang ◽  
...  
Keyword(s):  
Information Technology ◽  
Computer Use ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Age Group ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Type Headache ◽  
One Year ◽  
The One

Abstract Background To date, there have been very few studies that have explored the relationship between headaches and computer use. The chief aim of this study is to investigate the prevalence of primary headache disorders among informational technology staff and identify the potential factors contributing to it. Methods This is a cross-sectional study based on annual health checks of employees from the information technology industry. We identified 2216 information technology staff members from Beijing by stratified random sampling who met the inclusion criteria. All participants were initially required to have a physical examination, after which they complete a general situation questionnaire that included a headache screening question. Those who had suffered from headache within the previous year also completed the questionnaire developed by Lifting the Burden. The International Classification of Headache Disorders 3(ICHD-3) criteria was used for the diagnosis of headache. Results A total of 2012 valid questionnaires (males, 1544; females, 468) were obtained from 2216 participants for a response rate of 90.8%. A total of 619 participants were diagnosed with primary headache, the one-year prevalence of which was 30.8%. Regarding the classification of the primary headache, 152 participants suffered from migraine, with a one-year prevalence of 7.6%; 440 and 27 suffered from tension-type headache and unclassified headaches, with one-year prevalences of 21.9% and 1.3%, respectively. Multivariate regression analysis showed that female gender was a risk factor for migraine and tension-type headache (OR 3.21 and 1.88, respectively). Age was also related to migraine and tension-type headache. The 41-50 age group had 2.02 times the probability of migraine, and the 31-40 age group had 1.89 times the probability of tension-type headaches compared to the 18-30 age group. Obesity and excessive computer use (more than 12 hours per day) were also factors contributing to tension-type headache (OR: 2.61 and 1.63, respectively). Conclusions The one-year prevalence of primary headache in this population was 30.8%. The prevalence of tension-type headache in this population was higher than that in the general Chinese population. The occurrence of primary headache is correlated with many factors, among which excessive computer use significantly contributed to the risk of tension-type headache.

Prevalence of primary headache disorders diagnosed according to ICHD-3 beta in three different social groups

Cephalalgia ◽  
2015 ◽  
Vol 36 (6) ◽  
pp. 579-588 ◽  
Author(s):  
Elena R Lebedeva ◽  
Natalia R Kobzeva ◽  
Denis Gilev ◽  
Jes Olesen
Keyword(s):  
Blood Donors ◽  
Medication Overuse Headache ◽  
Social Groups ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Type Headache ◽  
One Year ◽  
Age Range

Background The aim of our study was to estimate the one-year prevalence of primary headache disorders in three different social groups using the third edition beta of the International Classification of Headache Disorders (ICHD-3 beta). Material and methods The study population included a total of 3124 participants: 1042 students (719 females, 323 males, mean age 20.6, age range 17–40), 1075 workers (146 females, 929 males, mean age 40.4, age range 21–67) and 1007 blood donors (484 females, 523 males, mean age 34.1, age range 18–64). We used a semi-structured, validated face-to-face interview. Results The age-adjusted one-year prevalence of migraine in females was significantly higher ( p < 0.001) in students (41.9%) than in workers (19.2%) and blood donors (18.7%). Age-adjusted prevalence of migraine among males did not differ among the three groups: 4.5% in students, 4.9% in workers and 4.5% in blood donors. Age-adjusted prevalence of tension-type headache (TTH) among females was almost the same in students and blood donors (68.8% and 66.7%) but female workers had a lower prevalence of TTH (57%). Age-adjusted prevalence of TTH among males did not differ significantly between students and blood donors (55.8% and 58.1%) but male workers had a significantly lower ( p < 0.001) prevalence of TTH (30.7%). The prevalence of chronic headache in students (TTH and/or migraine) was 3% and of probable medication-overuse headache 3%, significantly more than in workers and blood donors. Conclusion Headache prevalence was high and differed markedly among the three social groups. It is important that headache epidemiology also focus on socially defined groups in order to target future preventive efforts.

Functional Connectivity between Trigeminal and Occipital Nerves Revealed by Occipital Nerve Blockade and Nociceptive Blink Reflexes

Cephalalgia ◽  
2006 ◽  
Vol 26 (1) ◽  
pp. 50-55 ◽  
Author(s):  
V Busch ◽  
W Jakob ◽  
T Juergens ◽  
W Schulte-Mattler ◽  
H Kaube ◽  
...  
Keyword(s):  
Pain Perception ◽  
Primary Headache ◽  
Repeated Measurements ◽  
Afferent Pathways ◽  
Nerve Blockade ◽  
Occipital Nerve ◽  
Primary Headache Disorders ◽  
Nociceptive Blink Reflex ◽  
Greater Occipital Nerve ◽  
Neurophysiological Studies

Headache syndromes often suggest occipital and neck involvement, although it is still unknown to what extent branches of segment C1-C3 contribute actively to primary headache. Pain within the occipital area may be referred to the trigeminal territory. However, a modulation of trigeminal transmission by affecting cervical input in humans has not been elucidated so far. A convergence of cervical and trigeminal input at the level of the caudal part of the trigeminal nucleus in the brainstem has been suggested due to anatomical and neurophysiological studies in animals. We examined the R2 components of the nociceptive blink reflex responses in 15 healthy subjects before and after unilateral nerve blockade of the greater occipital nerve with 5 ml prilocain (1%). R2 response areas (AUC) decreased and the R2 latencies increased significantly after the nerve blockade only on the side of injection. AUC and latencies on the non-injection side remained stable. Thresholds for sensory or pain perception did not differ significantly between the repeated measurements on both sides. Our findings extend previous results related to anatomical and functional convergence of trigeminal and cervical afferent pathways in animals and suggest that the modulation of this pathway is of potential benefit in primary headache disorders.

Occipital nerve stimulation for intractable chronic cluster headache or migraine: A critical analysis of direct treatment costs and complications

Cephalalgia ◽  
2013 ◽  
Vol 33 (16) ◽  
pp. 1283-1291 ◽  
Author(s):  
Oliver Mueller ◽  
Hans-Christoph Diener ◽  
Philipp Dammann ◽  
Kasja Rabe ◽  
Vincent Hagel ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Nerve Stimulation ◽  
Chronic Cluster Headache ◽  
Treatment Costs ◽  
Headache Disorders ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Primary Headache Disorders ◽  
Direct Treatment ◽  
Hospitalization Costs

Background Occipital nerve stimulation (ONS) has been shown to be effective for selected patients with intractable headache disorders. We performed a prospective critical evaluation of complications and direct treatment costs. Methods Twenty-seven patients with chronic cluster headache (CCH, n = 24) or chronic migraine (CM, n = 3) underwent a trial phase with bilateral ONS and subsequent implantation of a permanent generator (IPG), if responsive to treatment according to predefined criteria. Procedural and long-term complications as well as direct treatment costs of neuromodulation therapy of ONS were recorded over a mean follow-up period of 20 months (range 5–47 months). Results Twenty-five of 27 patients (93%) responded to treatment. Twenty-one complications in 14 patients were identified, necessitating reoperation in 13 cases. Overall treatment costs were €761,043, including hardware-related costs of €506,019, costs for primary hospital care of €210,496, and complications related to hospitalization costs of €44,528. This results in a per case-based cost of €9445 for hospitalization and €18,741 for hardware costs, totaling €28,186. Conclusion ONS for treatment of refractory CCH and CM is a cost-intensive treatment option with a significant complication rate. Nevertheless, patients with refractory primary headache disorders may experience substantial relief of pain attacks, and headache days, respectively.

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