TY - JOUR
T1 - Treatment Update of Chronic Migraine
AU - Cho, Soo Jin
AU - Song, Tae Jin
AU - Chu, Min Kyung
N1 - Funding Information:
Soo-Jin Cho declares grant support from the Korean Neurological Society and Hallym University Research Fund 2016, lecture honoraria from Yuyu Pharmaceutical Company, and serving as a site investigator of a multicenter trial for Eli Lilly and Company.
Funding Information:
Min Kyung Chu declares grant support from Hallym University Research Fund 2016, serving as a site investigator of a multicenter trial for Eli Lilly and Company, and honoraria payments from Allergan Korea and Yuyu Pharmaceutical Company.
Publisher Copyright:
© 2017, Springer Science+Business Media New York.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Purpose of Review: Although chronic migraine (CM) is a common disorder that severely impacts patient functioning and quality of life, it is usually underdiagnosed, and treatment responses often remain poor even after diagnosis. In addition, effective treatment options are limited due to the rarity of randomized controlled trials (RCTs) involving patients with CM. In the present review, we discuss updated pharmacological, non-pharmacological, and neurostimulation treatment options for CM. Recent Findings: Pharmacological treatments include both acute and preventive measures. While acute treatment options are similar between CM and episodic migraine (EM), preventive treatment with topiramate and botulinum toxin A exhibited efficacy in more than two RCTs. In addition, several studies have revealed that behavioral interventions such as cognitive behavioral therapy, biofeedback, and relaxation techniques are associated with significant improvements in symptoms. Thus, these treatment options are recommended for patients with CM, especially for refractory cases. Neurostimulation procedures, such as occipital stimulation, supraorbital transcutaneous stimulation, non-invasive vagal nerve stimulation, and transcranial direct current stimulation, have shown promising results in the treatment of CM. However, current studies on neurostimulation suffer from small sample size, no replication, or negative results. Summary: Although CM is less responsive to treatment compared to EM, recent advance in pharmacological, non-pharmacological, and neurostimulation treatments may provide more chance for successful treatment of CM.
AB - Purpose of Review: Although chronic migraine (CM) is a common disorder that severely impacts patient functioning and quality of life, it is usually underdiagnosed, and treatment responses often remain poor even after diagnosis. In addition, effective treatment options are limited due to the rarity of randomized controlled trials (RCTs) involving patients with CM. In the present review, we discuss updated pharmacological, non-pharmacological, and neurostimulation treatment options for CM. Recent Findings: Pharmacological treatments include both acute and preventive measures. While acute treatment options are similar between CM and episodic migraine (EM), preventive treatment with topiramate and botulinum toxin A exhibited efficacy in more than two RCTs. In addition, several studies have revealed that behavioral interventions such as cognitive behavioral therapy, biofeedback, and relaxation techniques are associated with significant improvements in symptoms. Thus, these treatment options are recommended for patients with CM, especially for refractory cases. Neurostimulation procedures, such as occipital stimulation, supraorbital transcutaneous stimulation, non-invasive vagal nerve stimulation, and transcranial direct current stimulation, have shown promising results in the treatment of CM. However, current studies on neurostimulation suffer from small sample size, no replication, or negative results. Summary: Although CM is less responsive to treatment compared to EM, recent advance in pharmacological, non-pharmacological, and neurostimulation treatments may provide more chance for successful treatment of CM.
KW - Behavioral treatment
KW - Chronic daily headache
KW - Chronic migraine
KW - Headache
KW - Migraine
KW - Pharmacological treatment
UR - http://www.scopus.com/inward/record.url?scp=85018497388&partnerID=8YFLogxK
U2 - 10.1007/s11916-017-0628-6
DO - 10.1007/s11916-017-0628-6
M3 - Review article
C2 - 28424953
AN - SCOPUS:85018497388
SN - 1531-3433
VL - 21
JO - Current Pain and Headache Reports
JF - Current Pain and Headache Reports
IS - 6
M1 - 26
ER -