Implant for migraine headaches is tested

Chronic migraine sufferers may be able to zap their pain away one day.

Medtronic Inc. said the first test patient has been implanted with a device to deliver electrical impulses that might relieve migraine symptoms that didn’t respond to other treatments.

The Medtronic device, called Synergy, already treats back pain and Parkinson’s disease, but some doctors think it will relieve migraine sufferers too. Synergy costs about $25,000 for the device and the procedure to implant it.

It likely would be put in the abdomen or buttocks and send impulses through wires tunneled under the skin to nerves at the base of the head.

A 47-year-old woman who has had chronic headaches for eight years is the first patient in a 68-patient feasibility study to see whether the treatment warrants more investigation, Kyra Schmitt, a spokeswoman for the Fridley, Minn., medical device company said last week.

Richard Weiner of the Dallas Neurosurgical Association pioneered the approach that the Synergy device might put into wider use.

“I had a woman patient from east Texas who loved fishing but had to spend much of her life in a darkened room on narcotics,” Weiner said. “Now she’s out of the house and back fishing.”

Weiner said he has treated hundreds of patients with the device over the past 10 years and has had a success rate of about 75 percent.

The National Headache Foundation estimates 28 million Americans have migraine headaches - 70 percent of them women - and that they lose about 157 million workdays each year. Many migraine sufferers progress to a chronic condition in which they experience headaches more than 15 days per month.

Although the majority of chronic migraine sufferers can be helped with drugs or other treatments, Medtronic estimates about 40,000 people in the United States do not respond to existing treatments. In some of the worst cases, doctors resorted to operating on these patients to strip out some of the nerves in the scalp or the upper neck that caused the migraines.

Medtronic’s new treatment could make that surgery unnecessary in some cases.

“I’ve seen patients get their lives, their livelihoods and their marriages back because of this,” Weiner said. “There have been such dramatic improvements that now we’re ready to take it to the next step.”

Migraines are the latest in a growing list of diseases and disorders that are being treated with implantable devices. The technology dates back to 1957, when Medtronic founder Earl Bakken invented the world’s first external heart pacemaker.

Today, implants are used to treat a wide variety of disorders besides heart disease, such as fecal and urinary incontinence, congestive heart failure, chronic pain, diabetes, epilepsy and Parkinson’s disease.

Over the years, pacemakers and defibrillators have saved millions of lives and revolutionized cardiac care. Borrowing on pacemaker technology, surgeons now implant neurostimulators to control tremors in patients with Parkinson’s and seizures in those with epilepsy.

Surgeons also use the devices to block pain signals in the spines of patients who experience intractable pain.

Implantable neurostimulators control various pelvic muscles in patients with debilitating urinary and fecal incontinence.

In addition, researchers have developed sophisticated implantable pumps that send steady doses of insulin into diabetes patients’ bodies and powerful opiates into the spines of patients suffering intractable pain.

Provided by ArmMed Media
Revision date: June 20, 2011
Last revised: by Jorge P. Ribeiro, MD