Long-Term Efficacy of Occipital Nerve Stimulation for Medically Intractable Cluster Headache.

Details

Serval ID
serval:BIB_3540954F7EDE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long-Term Efficacy of Occipital Nerve Stimulation for Medically Intractable Cluster Headache.
Journal
Neurosurgery
Author(s)
Leplus A., Fontaine D., Donnet A., Regis J., Lucas C., Buisset N., Blond S., Raoul S., Guegan-Massardier E., Derrey S., Jarraya B., Dang-Vu B., Bourdain F., Valade D., Roos C., Creach C., Chabardes S., Giraud P., Voirin J., Bloch J., Colnat-Coulbois S., Caire F., Rigoard P., Tran L., Cruzel C., Lantéri-Minet M.
Working group(s)
French ONS registry group
ISSN
1524-4040 (Electronic)
ISSN-L
0148-396X
Publication state
Published
Issued date
13/01/2021
Peer-reviewed
Oui
Volume
88
Number
2
Pages
375-383
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Occipital nerve stimulation (ONS) has been proposed to treat refractory chronic cluster headache (rCCH) but its efficacy has only been showed in small short-term series.
To evaluate ONS long-term efficacy in rCCH.
We studied 105 patients with rCCH, treated by ONS within a multicenter ONS prospective registry. Efficacy was evaluated by frequency, intensity of pain attacks, quality of life (QoL) EuroQol 5 dimensions (EQ5D), functional (Headache Impact Test-6, Migraine Disability Assessment) and emotional (Hospital Anxiety Depression Scale [HAD]) impacts, and medication consumption.
At last follow-up (mean 43.8 mo), attack frequency was reduced >50% in 69% of the patients. Mean weekly attack frequency decreased from 22.5 at baseline to 9.9 (P < .001) after ONS. Preventive and abortive medications were significantly decreased. Functional impact, anxiety, and QoL significantly improved after ONS. In excellent responders (59% of the patients), attack frequency decreased by 80% and QoL (EQ5D visual analog scale) dramatically improved from 37.8/100 to 73.2/100. When comparing baseline and 1-yr and last follow-up outcomes, efficacy was sustained over time. In multivariable analysis, low preoperative HAD-depression score was correlated to a higher risk of ONS failure. During the follow-up, 67 patients experienced at least one complication, 29 requiring an additional surgery: infection (6%), lead migration (12%) or fracture (4.5%), hardware dysfunction (8.2%), and local pain (20%).
Our results showed that long-term efficacy of ONS in CCH was maintained over time. In responders, ONS induced a major reduction of functional and emotional headache-related impacts and a dramatic improvement of QoL. These results obtained in real-life conditions support its use and dissemination in rCCH patients.
Keywords
Adult, Aged, Cluster Headache/therapy, Electric Stimulation Therapy/methods, Female, Humans, Middle Aged, Peripheral Nerves/physiology, Quality of Life, Treatment Outcome, Cluster headache, Intractable, Neuromodulation, Occipital nerve stimulation, Quality of life
Pubmed
Web of science
Create date
05/10/2020 13:11
Last modification date
08/07/2021 5:37
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