QST and ONS
Research type
Research Study
Full title
Does occipital nerve stimulation alter pain response as measured by quantitative sensory testing in patients with chronic migraine or cluster headache.
IRAS ID
210723
Contact name
Vivek Mehta
Contact email
Sponsor organisation
Barts Health NHS Trust
Duration of Study in the UK
1 years, 5 months, 1 days
Research summary
Headache is one of the most common neurological problems accounting for 4% of primary care consultations and up to 30% of neurology appointments. Even though many advances in the understanding of the causes of migraine, new pharmacologic treatments and the emergence of new innovative interventions for difficult cases, in many patients with migraine remain intractable to medical therapy. Neurostimulation techniques for treating headache range from invasive deep brain stimulation to less invasive peripheral implantation and stimulation. In 1999 the benefits of subcutaneous Occipital nerve stimulation (ONS) in patients with medically intractable, highly disabling chronic headache disorders. Studies have suggested that this treatment is effective and safe. Although the exact mechanism of action of ONS is poorly understood. Quantitative sensory testing (QST) has the particular advantage of being a functional test that provides a quantitative pain stimulus and assesses the subject’s individual response to the stimulus. QST also provides a reliable assessment of changes in pain thresholds and the benefit of ONS as currently there is no tests that demonstrate efficacy other than global questionnaires. In this study we will perform QST on patients undergoing ONS at baseline, 4 weeks post insertion of ONS and then at 3, 6 and 12 months and compare with patients undergoing a surgical procedure of non painful aetiology as it has been suggested that the changes seen with ONS maybe due to general anaesthetic. We will also have a group of healthy subjects to compare QST results. All patients will be given questionnaires prior to proceedure and there after. Blood/saliva samples will also be taken before and after which will measure levels of immune cells which have been associated with headache progression.
REC name
London - Queen Square Research Ethics Committee
REC reference
19/LO/0479
Date of REC Opinion
16 Apr 2019
REC opinion
Further Information Favourable Opinion