Occipital nerve stimulation (ONS) is a specific form of peripheral neuromodulation used to treat chronic pain conditions. A particular application is the therapy of headache disorders that do not respond to other treatments. The exact mechanism of action is unknown. A reduction in central and peripheral sensitization in patients with chronic headaches is assumed. The aim of this study is to investigate the effect of ONS on pain-modulating mechanisms in the trigeminal-cervical region in patients with chronic migraine.

A balanced repeated-measures plan was used to analyze the effects of ONS on the dynamically airflow-triggered orbicularis oculi reflex in patients with chronic migraine with and without active ONS.

When taking into account the difference to the respective baseline, the orbicularis oculi reflex is significantly suppressed by approximately 60.64% in active ONS compared to inactive ONS.

The results show that under active ONS, compared to inactive ONS, the orbicularis oculi reflex, dynamically triggered by a standardized airflow, is significantly attenuated in patients with chronic migraine. This suggests that ONS is able to directly counteract trigeminally mediated central sensitization in chronic migraine and to protectively reduce the effects of aversive peripheral stimulation.

Link to the full study:

https://link.springer.com/article/10.1007%2Fs40122-021-00242-3

Göbel, CH, et al. (2021). “Effect of Occipital Nerve Stimulation (ONS) on the Orbicularis Oculi Reflex Triggered by a Standardized Air Flow in Patients with Chronic Migraine—A Prospective, Randomized, Interventional Study.” Pain and Therapy .

Occipital nerve stimulation (ONS) is a specific form of peripheral neuromodulation used in the treatment of chronic pain disorders. A particular field of application is in the therapy of treatment-refractory headaches, especially of chronic migraine. The precise mode of action is unknown. It is presumed that central and peripheral sensitization are reduced in patients with chronic headache. The aim of this study was to examine the effect of ONS on pain-modulatory mechanisms in the trigeminocervical area in patients with chronic migraine.

Carl H. Göbel & Sarah Karstedt; Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany;
Axel Heinze, Svenja Clasen & Hartmut Göbel; Kiel Migraine and Headache Centre, Kiel, Germany