Migraine is a common chronicneurovascular disease characterized by recurrent, unilateral or bilateralpulsatile severe headache and occurs mostly in the hemiplegic head, which canbe accompanied byautonomic nervous system dysfunction suchas nausea, vomiting, photophobia and phonophobia. In addition to damage causedby the disease itself, migraine can also lead to white matter lesions,cognitive decline, asymptomatic cerebral infarction of posterior circulationand so on (1).
The prevalence of migraine in China is9.3%, and the female-to-male ratio is approximately 3:1. In addition, frequentmigraine attacks are complicated by complex psycho-psychological, emotional,and sleep functional changes. Migraine is the second most disabling ailmentworldwide in patients from adolescence to advanced age(2). The World Health Organization (WHO) hasclassified severe migraine as one of the most disabling chronic diseases, whichseriously affects human health and quality of life and places a heavy economicburden (3).
Migraine is not yet curable, but it canbe effectively controlled by medical or non-pharmacological treatment, toreduce or discontinue headache attacks, relieve associated symptoms, andprevent headache recurrence, thereby improve quality of life (4).
Drugsinclude prescription and over-the-counter analgesic drugs, which are selectedaccording to the severity of headache, accompanying symptoms, previousmedication, and the individual condition of the patient (5). Itis worth noting that the treatment of drugs brings more side effects topatients, and even some patients discontinue treatment or change to refractoryheadache for this reason, seriously affecting the quality of life (6).
Existingnon-pharmacological treatments mainly include neuromodulation techniques,acupuncture therapy, behavioral therapy and lifestyle modification.Neuromodulation is a non-invasive treatment, and the techniques used to treatmigraine mainly include transcranial direct current stimulation (tDCS)and transcutaneous electrical nerve stimulation (TENS). TENS is to infuseappropriate intensity of low-frequency pulse current into the human bodythrough skin surface electrodes to activate the corresponding nerves, and itstarget nerves include the vagusnerve, trigeminal nerve, and occipital nerve, and previous studies have shownthat TENS can be used alone to treat mild to moderate pain or in combinationwith drugs to treat moderate to severe pain and is well tolerated (6).
Relivionis a non-invasive transcutaneous electrical nerve stimulator developed by Neurolief,an Israel company, through the innovation of transcutaneous occipital nervestimulation technology, which performs combined occipital nerve and trigeminalnerve stimulation by transcutaneous nerve stimulation to provide a safe,effective and rapid onset of treatment for reducing migraine-related pain.
The overseas clinical studiesshowed that when Relivionwas used for the treatment of patients with acute migraine, the pain wassignificantly relieved: more than 60% of patients had headache relief (37% inthe control group), nearly 50% of patients were pain-free (11%in the control group), and 75% of patients had disappearance of most bothersome symptom (MBS)(47%in the control group) 2 hours after the treatment, and the subjects had a goodoverall impression of its treatment effect and good safety.
Relivion wasapproved in EU for the treatment of migraine in adults in July 2019; approved byFDA in February 2021 for the treatment of migraine in adults with or withoutaura.
Reference:
1. 中华医学会疼痛学分会头面痛学组，中国偏头痛防治指南，中国疼痛杂志 2016,22(10), 721-727. DOI:10.3969/j.issn.1006—9852.2016.10.001.
2. Oved Daniel, et al. A devicereview of Relivion®: anexternal combined occipital and trigeminal neurostimulation (eCOT-NS)system for self-administered treatment of migraine and majordepressive disorder. Expert Review Of Medical Devices 2021, VOL. 18,NO. 4, 333–342. DOI: 10.1080/17434440.2021.1908122.
3. Itzhak Levav, et al. The WHO World Health Report2001-New Understanding-New Hope. The Israel Journal of Psychiatry and RelatedSciences; 2002; 39, 1, 50-56.
4. Hans-Christoph Diener, et al.Guidelines of the International Headache Society for controlled trials of acutetreatment of migraine attacks in adults: Fourth edition. Cephalalgia 2019, Vol. 39(6)687–710. DOI:10.1177/0333102419828967.
5. 于生元，陈敏，成人偏头痛的药物治疗策略，中国新药杂志. 2014,23(14):1631-1636.
6. 于生元，刘颖璐，经皮神经电刺激治疗头痛的研究现状，中国疼痛医学杂志2017,23 (2):126-128. DOI:10.3969/j.issn.1006-9852.2017.02.010
