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枕神经刺激治疗慢性偏头痛的安全性和有效性:随机、双盲、对照、单中心经验。

Safety and Efficacy of Occipital Nerves Stimulation for the Treatment of Chronic Migraines: Randomized, Double-blind, Controlled Single-center Experience.

机构信息

Pain Management Department, Cleveland Clinic, Cleveland, Ohio, U.S.A.

Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, U.S.A.

出版信息

Pain Pract. 2017 Jun;17(5):669-677. doi: 10.1111/papr.12504. Epub 2016 Oct 25.

DOI:10.1111/papr.12504
PMID:27779368
Abstract

BACKGROUND

A recent multicenter study presented 52-week safety and efficacy results from an open-label extension of a randomized, sham-controlled trial for patients with chronic migraine (CM) undergoing peripheral nerve stimulation of the occipital nerves. We present the data from a single center of 20 patients enrolled at the Cleveland Clinic's Pain Management Department.

METHODS

In this single center, 20 patients were implanted with a neurostimulation system, randomized to an active or control group for 12 weeks, and received open-label treatment for an additional 40 weeks. Outcomes collected included number of headache days, pain intensity, Migraine Disability Assessment (MIDAS), Zung Pain and Distress (PAD), direct patient reports of headache pain relief, quality of life, satisfaction, and adverse events (AEs).

RESULTS

Headache days per month were reduced by 8.51 (±9.81) days (P < 0.0001). The proportion of patients who achieved a 30% and 50% reduction in headache days and/or pain intensity was 60% and 35%, respectively. MIDAS and Zung PAD were reduced for all patients. Fifteen (75%) of the 20 patients at the site reported at least one AE. A total of 20 AEs were reported from the site.

CONCLUSION

Our results support the 12-month efficacy of 20 CM patients receiving peripheral nerve stimulation of the occipital nerves in this single-center trial.

摘要

背景

最近一项多中心研究展示了一项针对慢性偏头痛(CM)患者的开放性延伸试验的 52 周安全性和疗效结果,该试验对枕神经进行外周神经刺激。我们报告了克利夫兰诊所疼痛管理部门的 20 名患者的单一中心数据。

方法

在这个单一中心,20 名患者植入了神经刺激系统,随机分为活性组或对照组进行 12 周治疗,并接受了另外 40 周的开放性治疗。收集的结果包括头痛天数、疼痛强度、偏头痛残疾评估(MIDAS)、Zung 疼痛和痛苦量表(PAD)、直接患者报告的头痛缓解情况、生活质量、满意度和不良事件(AEs)。

结果

每月头痛天数减少了 8.51(±9.81)天(P<0.0001)。达到头痛天数和/或疼痛强度减少 30%和 50%的患者比例分别为 60%和 35%。所有患者的 MIDAS 和 Zung PAD 均降低。该中心的 20 名患者中有 15 名(75%)报告了至少一次 AEs。该中心共报告了 20 次 AEs。

结论

我们的结果支持在这项单中心试验中,20 名接受枕神经外周神经刺激的 CM 患者在 12 个月时的疗效。

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