Occipital Nerve Stimulation in Chronic Migraine: The Relationship Between Perceived Sensory Quality, Perceived Sensory L
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ORIGINAL RESEARCH
Occipital Nerve Stimulation in Chronic Migraine: The Relationship Between Perceived Sensory Quality, Perceived Sensory Location, and Clinical Efficacy—A Prospective, Observational, Non-Interventional Study ¨ bel Carl H. Go
. Anna Go¨bel . Uwe Niederberger . Axel Heinze . Katja Heinze-Kuhn .
¨ bel Christoph Meinecke . Hubertus M. Mehdorn . Dirk Rasche . Hartmut Go
Received: July 23, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Occipital nerve stimulation (ONS) is used to treat therapy-resistant chronic migraine. Clinical use has resulted in a wide intraindividual and interindividual variation of clinical efficacy. The aim of this study was to analyze a potential relationship between sociodemographic variables, headache parameters, perceived sensory quality, perceived sensory location, as well as clinical efficacy. Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12859901. ¨ bel A. Go ¨ bel A. Heinze K. Heinze-Kuhn C. H. Go ¨ bel C. Meinecke H. Go Kiel Migraine and Headache Centre, Kiel, Germany ¨ bel (&) A. Go ¨ bel C. H. Go Department of Neurology, University Hospital ¨ beck, Lu ¨ beck, Schleswig-Holstein, Campus Lu Germany e-mail: [email protected] U. Niederberger Institute of Medical Psychology and Medical Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany H. M. Mehdorn Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany D. Rasche Department of Neurosurgery, University Hospital ¨ beck, Lu ¨ beck, Schleswig-Holstein, Campus Lu Germany
Methods: Thirty-two subjects (21.9% male, mean age 45.77 years) suffering from chronic migraine refractory to other treatment and therefore treated with ONS were included in this study. We used a computer-based imaging method for mapping the ONS-induced perceived sensory location, the perceived spatial sensory field size, as well as the perceived sensory quality in a long-term course over 21 months in weekly time intervals. Additionally, the effect of ONS on the migraine headache was documented weekly by the participants using a verbal rating scale. Over the observation period, a total of 808 individual weekly data sets were recorded and a potential relationship between ONS-induced perceptions and headache parameters could be analyzed. Results: We found that 48.9% of stimulation intervals were reported as effective by patients. Women displayed a significantly higher responder rate than men. The reported effectiveness did not differ depending on age, the average number of migraine days per month, the MIDAS score, or the duration of the migraine disorder prior to ONS treatment. Implantation with trial period led to significantly lower responder rates than without the trial period. The most frequently perceived sensory quality of ‘‘tingling’’ was found significantly more frequently in non-responders than in responders. Responders displayed significantly lower pleasantness scores for their reported perceptions tha
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