Blog Post

By Dr Mozaffar Hossain MBBS. MD.

Consultant Neuro-Psychiatrist.

Dear colleagues and friends,

As a board-certified Neuropsychiatrist and headache specialist, I would like to share with you some of the recent advances in headache treatment that have been published in the past year. As you may know, headache is one of the most common and disabling neurological conditions, affecting millions of people worldwide. However, many patients still struggle to find effective and safe treatments for their chronic or episodic pain.

That is why I am always excited to learn about new developments in the field of headache medicine. These include novel pharmacological, non-pharmacological, and interventional approaches that target different aspects of the headache pathophysiology and offer new options for patients who do not respond to conventional therapies.

In this post, I will briefly review three of these innovative treatments that have caught my attention and that I believe have great potential for improving the quality of life of headache sufferers. These are:

1) Galcanezumab: This is a monoclonal antibody that blocks the activity of calcitonin gene-related peptide (CGRP), a protein that is involved in the transmission and modulation of pain signals in the brain. CGRP has been shown to be elevated during migraine and cluster headache attacks, and blocking it can reduce the frequency and severity of these headaches. Galcanezumab was approved by the FDA in 2020 for the prevention of episodic cluster headache, a rare but extremely painful condition that causes recurrent attacks of unilateral orbital pain with autonomic symptoms. It is administered by subcutaneous injection once a month and has been shown to reduce the number of cluster headache attacks by more than 50% in some patients.

2) Non-invasive vagus nerve stimulation (nVNS): This is a device that delivers mild electrical impulses to the vagus nerve, a cranial nerve that connects the brain to various organs and modulates inflammation, immunity, and pain. The vagus nerve has been implicated in the pathogenesis of headache disorders, and stimulating it can activate anti-nociceptive pathways and inhibit pro-inflammatory cytokines. nVNS is a handheld device that is applied to the neck for 2 minutes during a headache attack or as a preventive measure. It was approved by the FDA in 2020 for the acute treatment of episodic cluster headache and migraine. It has been shown to reduce pain intensity and abort headache attacks in some patients, with minimal side effects and no drug interactions.

3) Transcranial magnetic stimulation (TMS): This is a device that uses magnetic fields to induce electrical currents in the brain, stimulating or inhibiting specific brain regions. TMS has been used for various neurological and psychiatric conditions, such as depression, stroke, and epilepsy. It has also been shown to modulate cortical excitability and neurotransmitter levels in the brain, which are altered in headache disorders. TMS is a portable device that is applied to the back of the head for a few seconds during a headache attack. It was approved by the FDA in 2013 for the acute treatment of migraine with aura, a subtype of migraine that is preceded by visual or sensory disturbances. It has been shown to reduce pain intensity and prevent headache progression in some patients, with no serious adverse events or contraindications.

These are just some of the examples of the recent advances in headache treatment that I find fascinating and promising. Of course, these treatments are not suitable for everyone and may not work for every patient. They also require further research and clinical trials to establish their long-term safety and efficacy. However, they represent a significant step forward in the understanding and management of headache disorders, and offer hope and relief to many patients who suffer from this debilitating condition.

Thank you for reading and have a great day!