Non-Invasive Vagus Nerve Stimulation in Cluster Headache: A Clinical Practice Guideline

Area of Science:

• Neurology
• Pain Management
• Medical Devices

Background:

• Cluster headache (CH) is a severe primary headache disorder with debilitating unilateral pain and autonomic symptoms.
• CH attacks are characterized by specific durations and frequencies, occurring in clusters or chronically.
• Current pharmacological treatments for CH include triptans, oxygen, verapamil, corticosteroids, and galcanezumab.

Purpose of the Study:

• To review the clinical evidence for transcutaneous cervical vagus nerve stimulation (tcVNS) in treating cluster headache (CH).
• To evaluate tcVNS as an alternative to invasive neuromodulation for CH patients.
• To discuss the practical application of tcVNS in CH management.

Main Methods:

• Systematic review of clinical trials and real-world studies on tcVNS for CH.
• Analysis of guideline recommendations for neuromodulation in CH.
• Summary of evidence for both acute and preventive treatment of CH with tcVNS.

Main Results:

• TcVNS demonstrated significant reductions in cluster headache attack frequency and intensity.
• Clinical trials support tcVNS as a safe and effective non-invasive neuromodulation option.
• TcVNS has received FDA clearance and NICE approval for CH treatment.

Conclusions:

• TcVNS is a well-tolerated, non-invasive neuromodulatory treatment for cluster headache.
• It offers both acute and preventive therapeutic benefits for CH patients.
• This review provides evidence and guidelines for integrating tcVNS into clinical practice.