Related Experiment Video
Updated: Jul 11, 2025
05:40
Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache
Published on: July 29, 2021
8.0K
Functional outcomes between headache surgery and targeted botox injections: A prospective multicenter pilot study
Jeffrey E Janis1, Jason Hehr1, Maria T Huayllani1
1Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
JPRAS Open
|November 3, 2023
Summary
Peripheral trigger point deactivation surgery and botulinum neurotoxin A (BTA) injections both effectively treat chronic migraine. Surgery demonstrated superior outcomes in reducing headache intensity and work-related disability compared to BTA.
Area of Science:
- Neurology
- Surgical Interventions
- Pain Management
Background:
- Chronic migraine headaches (MH) represent a significant global cause of disability.
- Peripheral trigger points are implicated in the pathophysiology of chronic migraine.
- Evaluating and comparing treatment modalities for chronic migraine is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the functional outcomes of peripheral trigger point deactivation surgery versus botulinum neurotoxin A (BTA) treatment in patients with chronic migraine.
- To assess long-term efficacy of both surgical and BTA interventions for chronic migraine management.
Main Methods:
- A prospective, multicenter study included 44 patients with chronic migraine, allocated to surgery (n=33) or BTA (n=11) based on preference.
- Functional outcomes were evaluated using standardized tools: Migraine Headache Index (MHI), MIDAS (total, A, B), MWPLQ7, and MSQ v2.1.
- Assessments were conducted pre-treatment and at 1, 2, and 2.5 years post-treatment.
Main Results:
- Surgical treatment yielded statistically significant improvements in headache intensity (MIDAS B, p=0.0464) and reduced work-related disability (MWPLQ7, p=0.0120) compared to BTA.
- No significant differences between groups were observed for other functional outcomes.
- MHI, MIDAS total, MIDAS A, MIDAS B, and MWPLQ7 scores improved significantly over time irrespective of treatment (p<0.05); MSQ scores did not show significant change over time.
Conclusions:
- Both headache surgery and targeted BTA injections are effective in addressing peripheral trigger sites contributing to migraine pain.
- Surgical intervention demonstrated a statistically significant advantage in reducing headache intensity and work-related disability compared to BTA treatment.
- Further research may be warranted to explore the long-term impact on quality of life (MSQ) for both treatment modalities.
