If you’ve ever experienced a migraine, you understand just how incapacitating it can be. Sensitivities to light, sound, and even certain smells can trigger this intense headache, which can last for hours or even days. Unfortunately, adults aren’t the only ones who suffer; research indicates that around 10% of children aged 5 to 15 and 28% of teenagers experience migraines. Notably, about 50% of these children have their first migraine before turning 12. So, what treatment options are available for these young patients?
Historically, parents and healthcare providers have turned to medications for migraine relief, but these are not always effective. In adolescents, the benefits of medications often mirror those of placebos. However, cognitive behavioral therapies are emerging as promising alternatives for managing headaches at their onset. Excitingly, a new wearable device is being developed to assist migraine sufferers. Cincinnati Children’s Hospital is researching these innovative approaches, and the results are encouraging.
The CHAMP Study
A recent three-year study named CHAMP, conducted by Cincinnati Children’s, found that a placebo provided comparable relief to the two most frequently prescribed migraine medications, topiramate and amitriptyline. Instead of focusing solely on medication, the CHAMP study emphasized behavioral therapies to alleviate migraine pain. The 205 teens involved in the study reported an average of 11 headaches per month at the beginning, which decreased to just five per month by the study’s conclusion.
The findings indicate that regardless of whether participants were on amitriptyline, topiramate, or a placebo, they consistently experienced significant reductions in headache frequency and migraine-related disability for three years post-study. Remarkably, less than 10% of participants continued using preventive medication typically prescribed in clinical settings, with most reporting no medication use at various times.
Dr. Mark Jensen, Co-Director of the Headache Center at Cincinnati Children’s Hospital, noted that stopping medication for long-term migraine prevention appears to be safe. “Our research suggests that the components in the pills may not be crucial in achieving better migraine control,” he said. The study highlighted that those who maintained regular self-care practices—such as staying hydrated, getting adequate sleep, exercising regularly, and eating balanced meals—found considerable success in preventing migraine headaches. It was also suggested that participation in CHAMP might have positively influenced the brain development of the adolescents, a process that continues until around the age of 25.
The Nerivio Device
In addition, a study published in December 2020 in the journal Headache introduced a novel wearable device called Nerivio, designed to provide remote electrical neuromodulation at the onset of a headache. Manufactured by Theranica, an Israeli company, Nerivio received FDA approval in January for use in individuals aged 12 and older. The device is worn on the upper arm and controlled via a smartphone. At the early stages of a migraine, users activate the device for 45 minutes, during which it sends mild stimulation signals through the skin to disrupt the progression of the migraine.
In this study of 39 participants using the device at the onset of a migraine, 71% reported relief within two hours, and 35% felt completely pain-free at that time. Additionally, 54% of participants experienced a reduction in nausea, and 40% reported alleviated sensitivity to light and sound. Only one individual noted a temporary mild discomfort from the device.
“This study is the first to compare remote electrical neuromodulation with standard care treatment options for adolescents,” said Dr. Laura Smith, the endowed chair and director of neurology at Cincinnati Children’s and co-director of the Headache Center. “Migraines in adolescents often lead to reduced performance and increased absences from school and social events during a vital developmental period. Offering teens more effective and engaging migraine treatments can significantly benefit their lives.”
Conclusion
The encouraging results from both studies provide hope for children and teenagers grappling with migraines while avoiding long-term medication use. Evidence suggests that behavioral changes can be a valuable strategy for preventing migraine headaches. Once widely available, Nerivio may serve as an effective tool for managing migraines at their onset.
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In summary, recent research highlights promising new treatments for migraines in children, focusing on behavioral therapy and innovative wearable technology, offering hope for those seeking alternatives to traditional medication.