The use of focused ultrasound for the treatment of cutaneous allodynia associated with chronic migraine

Brain Res. 2018 Nov 15:1699:135-141. doi: 10.1016/j.brainres.2018.08.004. Epub 2018 Aug 2.

Abstract

Chronic migraines (CM) are the third most common disease and are refractory to medical treatment in 15% of patients. Currently, temporary relief is achieved with steroid blocks or pulsed radiofrequency ablation, which have short-term benefits. Our project aims to develop a non-invasive treatment for medically refractory chronic migraine, which does not require a permanent implant. This project investigates the safety and effectiveness of pulsed focused ultrasound (FUS) in a validated rodent headache model of cutaneous allodynia associated with chronic migraine (CM) as compared to sumatriptan and ablative lesioning. We demonstrate a significant reduction in mechanical thresholds as measured through Von Frey filaments in CM in the forepaw and periorbital region (p < 0.001). Sumatriptan and pulsed FUS both significantly improve thresholds at day 3 after treatment in the periorbital region. Ablative lesioning has no effect. This study provides initial evidence that FUS may provide an important therapeutic option for patients suffering from CM.

Keywords: Chronic migraine; Focused ultrasound; High intensity focused ultrasound; Mechanical threshold; Occipital nerve; Von Frey.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Disease Models, Animal
  • Hyperalgesia / etiology
  • Hyperalgesia / pathology
  • Hyperalgesia / physiopathology
  • Hyperalgesia / therapy*
  • Male
  • Migraine Disorders / complications
  • Migraine Disorders / pathology
  • Migraine Disorders / physiopathology
  • Migraine Disorders / therapy*
  • Pain Threshold
  • Peripheral Nerves / pathology
  • Random Allocation
  • Rats, Sprague-Dawley
  • Serotonin 5-HT1 Receptor Agonists / pharmacology
  • Skin
  • Sumatriptan / pharmacology
  • Ultrasonic Therapy*

Substances

  • Serotonin 5-HT1 Receptor Agonists
  • Sumatriptan