Date of Award

2023

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does non-invasive vagal nerve stimulation (nVNS) improve migraine headaches in adult patients?”

STUDY DESIGN: A systematic review of three randomized controlled trials (RCTs) published between 2011 and 2022.

DATE SOURCES: The studies were found in PubMed and were published in English peer-reviewed journals. The studies were selected based on if they contributed information toward the clinical question.

OUTCOMES MEASURED: Migraine symptom reduction was measured based on patient reported change in migraine pain and frequency from baseline.

RESULTS: The Diener et al. study found that utilizing nVNS 2-3 times a day for 12 months resulted in an average decrease of 2.27 days with migraines in participants in the treatment group and a 1.53 day reduction in the placebo group, there was a statistically significant shown by the p-value of 0.043. The Martelletti et al. study found that utilizing nVNS showed a statistically significant reduction of migraine pain by 25.4% at 60 minutes and 34.8% at 90 minutes compared to the sham group, which reduced 7.7% at 60 minutes and 5.4% at 90 minutes. They also found that utilizing nVNS resolved the migraine in 12.1% of participants at 60 minutes and 18.0% of participants at 90 minutes compared to sham, which resolved 5.6% of migraines in participants at 60 minutes and 10.5% at 90 minutes. The Najib et al.study found that utilizing nVNS resulted in 44.87% of the participants reporting >50% reduction of days with migraine pain, compared to 26.81% of days in the sham group, p-value of 0.0481.

CONCLUSION: Two studies found a significant decrease in days patients reported experiencing migraines while using nVNS. The other study found a significant reduction in migraine pain at 60 and 90 minutes after nVNS and a significant resolution of migraines for patients at 60 and 90 minutes after nVNS. These results indicate that nVNS can serve as a method for reducing and controlling migraine symptoms.

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