Occipital nerve stimulation (ONS) is a special form of peripheral neuromodulation for the treatment of chronic pain disorders. A special area of ​​application is the treatment of headache disorders that do not respond to other treatments. The exact mechanism of action is not known. 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 trigemino-cervical area in patients with chronic migraine.

The effects of ONS on the orbicularis oculi reflex triggered dynamically with an airflow were analyzed using a balanced repeated measurement plan in patients with chronic migraine with and without active ONS.

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

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

The 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 Center, Kiel, Germany