Decreasing the Risk of Lead Migration in Occipital Nerve Stimulation for Cluster Headache Using Dedicated Leads

Area of Science:

• Neurology
• Neurosurgery
• Pain Management

Background:

• Refractory chronic cluster headache (rCCH) poses significant challenges.
• Occipital nerve stimulation (ONS) is a potential treatment option.
• Anchored ONS-dedicated leads offer a novel approach.

Purpose of the Study:

• To evaluate the effectiveness of ONS with dedicated anchoring leads in rCCH patients.
• To assess the complication rate associated with this ONS system.
• To analyze impacts on headache frequency, medication use, and quality of life.

Main Methods:

• Prospective multicenter registry (2019-2024) of rCCH patients undergoing ONS.
• Utilized anchored ONS-dedicated leads for treatment.
• Assessed outcomes including attack frequency, medication use, quality of life (EQ-5D), functional (HIT-6), and emotional (HADS) impacts.
• Monitored complications: electrode migration, device malfunction, infections, and local pain.

Main Results:

• 40 patients followed for one year, 24 for two years.
• Mean weekly attack frequency decreased significantly from 24.3 to 12.7 (1 year) and 11.7 (2 years).
• Significant improvements observed in quality of life, functional, and emotional impacts.
• 16 patients (40%) experienced device-related complications: infection (7.5%), lead migration (5%), hardware dysfunction (15%), and local pain (12.5%).

Conclusions:

• ONS with dedicated anchoring leads demonstrates comparable effectiveness to previous ONS systems for rCCH.
• The dedicated leads show a low risk of migration.
• This ONS approach offers a viable treatment option for rCCH with a manageable complication profile.