Anyone who's ever experienced a migraine knows how excruciating these headaches can be—sometimes pushing you into a dark room, curtains drawn, in hopes of a quick end to the throbbing, painful misery. Prescription medications are available to help those who experience migraines regularly, but drug-free alternatives are largely limited to rest and simply waiting the headache out. Now, a new study suggests that there may be a drug-free alternative to treating some migraines: a hand-held transcranial magnetic stimulation device that, when held against the bottom of the back of the head, eased migraine symptoms in some study volunteers.
Migraines are caused by abnormal brain activity, typically brought on by certain foods, stress, or another trigger. In addition to being painful, the headaches can involve nausea, vomiting, and other symptoms. Some nerve pathways and chemicals in the brain appear to contribute to the symptoms, and it's this role in the process that the magnetic device is designed to interrupt, says Yousef Mohammad, professor of neurology at Ohio State University Medical Center, who is lead author of the new study.
The idea behind the device is that patients will use it when they enter the migraine's aura phase, a period of visual disturbance that can occur before the headache begins, says Mohammad, who is a consultant for the maker of the device, a California-based medical technology company called Neuralieve. Auras may involve seeing flashing lights, zigzag lines, or other visual hallucinations, or experiencing temporary blind spots, sensitivity to bright light, blurred vision, or eye pain. Further study is needed to see whether the device works during other phases of migraines or among migraine patients who don't experience aura, Mohammad says.
The device, about the size of a hair dryer, is put up against the back of the head, and users push a button to administer the magnetic pulse. The study showed it eliminated the headache within two hours for 39 percent of participants; 22 percent in the placebo group reported no pain two hours later. Study participants used the device twice per migraine episode within an hour of experiencing an aura. Up to three migraines were treated per patient over a three-month period.
Because few migraine sufferers experience auras, the device may not be useful for the majority of people who get these headaches, says Alvaro Pascual-Leone, director of the Berenson-Allen Center for Noninvasive Brain Stimulation at Harvard Medical School, who has studied transcranial magnetic stimulation but was not involved in the new study. "For those who do have aura, this kind of approach would be helpful, but for those who do not have the aura, this would not be helpful," Pascual-Leone says. An alternative approach, which Pascual-Leone and his colleagues are currently studying, is to use this technique to keep the headaches from happening in the first place.
The device is intended to stimulate the occipital cortex in the brain, which induces a signal meant to disrupt what's known as cortical spreading depression, a pattern of abnormal brain waves that is thought to precede migraine. Neuralieve is currently pursuing the Food and Drug Administration's approval for the device. A previous study also showed that this device was helpful in getting rid of migraines.
Still, the key to helping the majority of people who get frequent migraines may be to determine whether these devices are helpful in preventing the headaches—rather than treating them after they've already begun. "In terms of helping a large number of patients with headaches, preventing headaches to begin with would have a greater impact on the patient population," Pascual-Leone says.
It will most likely be at least six months before the new magnetic device hits the market—if Neuralieve's bid for FDA approval is successful. So for now, migraine sufferers should stick with currently available options that work for them. Here's a sampling of options.