title: An Update on Non-Pharmacological Neuromodulation for the Acute and Preventive Treatment of Migraine.
abstract: OBJECTIVE
  To review current neuromodulation treatments available for migraine therapy, both in the acute and preventive setting.
  
  
  METHODS
  The published literature was reviewed for studies reporting the effects of different neuromodulation strategies in migraine with and without aura. The use of non-invasive: single pulse transcranial magnetic stimulation, non-invasive vagal nerve stimulation, supraorbital nerve stimulation, and transcranial direct current stimulation, as well as invasive methods such as occipital nerve stimulation and sphenopalatine ganglion stimulation, are assessed.
  
  
  RESULTS
  The available evidence shows that non-invasive techniques represent promising treatment strategies, whereas an invasive approach should only be used where patients are refractory to other preventives, including non-invasive methods.
  
  
  CONCLUSIONS
  Neuromodulation is emerging as an exciting approach to migraine therapy, especially in the context of failure of commonly used medicines or for patients who do not tolerate common side effects. More studies with appropriate blinding strategies are needed to confirm the results of these new treatment opportunities.
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College (F. Puledda).
authors.forename: Francesca
authors.initials: F
authors.lastname: Puledda
authors.affiliation: Headache Group, NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, United Kingdom.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Goadsby
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D008881:Migraine Disorders / Q000517:prevention & control / Q000628:therapy*; D010525:Peripheral Nerves / Q000502:physiology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: migraine; neuromodulation; occipital nerve stimulation; sphenopalatine ganglion; transcranial magnetic stimulation; vagus nerve stimulation