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Practice-Based Consensus Amongst Indian Neurologists: Adopting Remote Electrical Neuromodulation for Effective
Debashish Chowdhury1, Jaydip Ray Chaudhuri2, Pravar Passi3
1Department of Neurology, GIPMER, New Delhi, India.
Introduction:
Migraine is a major cause of disability in India, disproportionately affecting women and adolescents. Although traditional pharmacological treatments exist, side effects and poor adherence have increased interest in non-pharmacological options such as remote electrical neuromodulation (REN). However, clinical adoption of REN remains limited because of the absence of clear, India-specific guidelines.
Methods:
An Indian consensus was developed through a two-phase Delphi process involving 49 neurologists. Phase 1 included a scientific committee of eight neurologists who conducted a targeted literature review on REN and formulated 27 consensus statements. In phase 2, 41 neurologists from across India participated in modified Delphi rounds to finalize these statements.
Results:
Statements achieving over 60% agreement identified REN as a promising and well-tolerated non-pharmacological therapy that addresses limitations of current migraine treatments. High consensus (75-97.22%) highlighted REN's favorable safety profile, minimal adverse events, and suitability for adolescents and women of childbearing age.
Conclusion:
This Indian consensus provides practical guidance for integrating REN into migraine management. The REN device shows potential as a first-line or adjunct therapy, particularly for patients facing challenges with pharmacological treatment adherence, supporting its wider adoption in clinical practice.
