Neurostimulation for Refractory Cervicogenic Headache: A Three-Year Retrospective Study

被引:12
|
作者
Eghtesadi, Marzieh [1 ]
Leroux, Elizabeth [2 ]
Fournier-Gosselin, Marie-Pierre [3 ]
Lesperance, Paul [4 ]
Marchand, Luc [2 ]
Pim, Heather [5 ]
Artenie, Andreea Adelina [6 ]
Beaudet, Line [7 ]
Boudreau, Guy Pierre [8 ]
机构
[1] CHUM, Ctr Rech, Dept Chron Pain & Headache Management, Montreal, PQ, Canada
[2] CHUM, Ctr Rech, Dept Gen Neurol & Headache Management, Montreal, PQ, Canada
[3] CHUM, Ctr Rech, Dept Surg, Montreal, PQ, Canada
[4] CHUM, Ctr Rech, Dept Psychiat, Montreal, PQ, Canada
[5] CHUM, Ctr Rech, Chron Pain & Headache Management, Dept Gen Neurol, Montreal, PQ, Canada
[6] CHUM, Ctr Rech, Sch Publ Hlth, Dept Social & Preventat Med, Montreal, PQ, Canada
[7] CHUM, Fac Nursing, Ctr Rech, Montreal, PQ, Canada
[8] CHUM, Ctr Rech, Dept Headache Management, Montreal, PQ, Canada
来源
NEUROMODULATION | 2018年 / 21卷 / 03期
关键词
Cervical radiculopathy; cervicogenic; neurostimulation; occipital headache; post-traumatic; OCCIPITAL NERVE-STIMULATION; CHRONIC CLUSTER HEADACHE; PERIPHERAL NEUROSTIMULATION; MIGRAINE PATIENTS; MECHANISMS; INJURIES; IMPACT;
D O I
10.1111/ner.12730
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: Occipital nerve stimulation (ONS) has been used for the treatment of neuropathic pain conditions and could be a therapeutic approach for refractory cervicogenic headache (CeH). Aim: The aim of this study is to assess the efficacy and safety of unilateral ONS in patients suffering from refractory CeH. Methods: We conducted a retrospective chart review on patients implanted from 2011 to 2013 at CHUM. The primary outcome was a 50% reduction in headache days per month. Secondary outcomes included change in EuroQol Group Visual Analog Scale rating of health-related quality of life (EQ VAS), six item headache impact test (HIT-6) score, hospital anxiety and depression scale (HADS) score, work status, and medication overuse. Results: Sixteen patients fulfilled the inclusion criteria; they had suffered from daily moderate to severe CeH for a median of 15 years. At one year follow-up, 11 patients were responders (69%). There was a statistically significant improvement in the EQ VAS score (median change: 40 point increase, p=0.0013) and HIT-6 score (median change: 17.5 point decrease, p=0.0005). Clinically significant anxiety and depression scores both resolved amongst 60% of patients. At three years, six patients were responders (37.5%). Out of the 11 responders at one-year post implantation, five had remained headache responders (R-R) and one additional patient became a responder (NR-R). There was a statistically significant improvement in the EQ VAS score (median change: 15 point increase, p=0.019) and HIT-6 score (median change: 7.5 point decrease, p=0.0017) compared with baseline. Clinically significant anxiety and depression scores both, respectively, resolved among 22.5% and 33.9% of patients. Five out of seven disabled patients were back to work. Conclusion: ONS may be a safe and effective treatment modality for patients suffering from a refractory CeH. Further study may be warranted.
引用
收藏
页码:302 / 309
页数:8
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