Tonabersat is a new drug undergoing And a phase of clinical research as a means for preventing migraine. Tonabersat is a blocker of pervasive cortical depression as the main mechanism of migraine pathogenesis.
In a double-blind, placebo-controlled trial, migraine patients received daily tonabersat at an initial dose of 20 mg for 2 weeks, increasing the daily dose to 40 mg over the next 10 weeks. According to the preliminary results of the study, the reduction of headache attacks by 50% or more was observed in 62% of patients taking tonabersat, and in 45% – placebo. The stimulation of the occipital nerve was studied as a possible alternative method for the prevention of trigeminal pain.
In a small study conducted with the participation of 15 patients who suffered persistent recurrent chronic headaches in the zone of innervation of the C2 segment, a stimulator of the occipital nerve was implanted. This group included patients with chronic migraine (N = 8), chronic cluster headaches (N = 3), post-traumatic headache (N = 2) and permanent hemicrania (N = 2).
Permanent hemikrania is a rare type of prolonged unilateral headache. In 8 patients the electrodes were located on both sides of the head, in 7 patients only on one side. After 20 months, the results of the study were presented. On average, headaches decreased by 52%; the best result was achieved in 2/3 of the patients: the frequency of attacks decreased more than twice. The frequency of headaches decreased by about one third.
The most common side effect in this study is the implant migration, which necessitated surgical intervention (N = 8). On the basis of these positive preliminary results, further research using implants will be conducted.