Percutaneous electrical nerve stimulation (PENS) therapy for refractory primary headache disorders: a pilot study

Area of Science:

• Neurology
• Pain Management
• Medical Devices

Background:

• Primary headache disorders, including chronic migraine and chronic cluster headache, frequently present treatment resistance.
• Existing medical treatments often fail to provide relief for a significant patient subset.

Purpose of the Study:

• To evaluate the efficacy of a 'single shot with single probe' percutaneous electrical nerve stimulation (PENS) strategy.
• To assess PENS therapy's benefit for patients with refractory chronic migraine (CM) and chronic cluster headache (CCH).

Main Methods:

• A service evaluation of 36 patients undergoing PENS therapy between 2012 and 2016.
• PENS applied to the occipital nerve using disposable probes, with stimulation parameters set at 2 Hz/100 Hz, 3 cycles/s, 1.2–2.5 V for 25–28 minutes.
• Follow-up data collected for 33 patients (16 CM, 9 CCH, 6 secondary headaches).

Main Results:

• Significant improvement was observed in six out of nine patients with CCH after the initial PENS session.
• One patient with CCH transitioned from chronic to episodic cluster headache.
• Only four patients with CM reported any benefit from the PENS therapy.

Conclusions:

• Percutaneous electrical nerve stimulation (PENS) therapy demonstrates potential as a low-risk, cost-effective treatment for refractory primary headache disorders.
• PENS therapy appears particularly beneficial for patients suffering from chronic cluster headache (CCH).
• Further investigation is warranted to optimize PENS for chronic migraine (CM).