Scientists Praise New Lidocaine Treatment For Migraine

these are catheters, similar to those discussed below

these are catheters, similar to those discussed below

A recent article came out summarizing the results of research from the Albany Medical Center claiming some big migraine results in a few short paragraphs. Apparently after just one administration of lidocaine to patients, 88% required less or no pain medication to provide additional relief. (1)

That is a huge statement to make.

As migraineurs we need a little more context to understand what that means. Most treatments I take don’t provide much relief during a migraine. So does this treatment prevent migraine attacks or does it just dull the pain? How long does the treatment last? Was this a preliminary trial or a clinical trial with stringent quality controls and a double blind placebo etc. 

I did a bit more digging to find some answers:

                                Dr Kenneth Mandato, lead researcher

                                Dr Kenneth Mandato, lead researcher

The treatment is a new innovative type of interventional radiology which was presented at the Society of Interventional Radiology’s Annual Scientific Meeting. These are big annual get togethers where researchers get out of their lab coats and into smart suits to present their work for the past year. Kenneth Mandato, M.D. is the lead researcher.

How does it work?

 They use an image-guided intranasal, yep – they go up your nose- catheter to administer the treatment to the nerve bundle just behind the nose which is associated with migraines. This area is called the sphenopalatine ganglion. The catheter is spaghetti sized and is reported to be minimally invasive as it does not involve any needles touching the patient.

How was the research conducted?

Mandato recruited 112 patients suffering migraine or cluster headaches. They reported the severity of their headaches using a visual analogue scale (VAS). This would be something pretty basic and similar to the image below ranging on a scale of 1-10.

                                                                             visual analogue scale (VAS)

                                                                             visual analogue scale (VAS)

What were the results?

Before the treatment patients reported an average VAS score of 8.25. With scores above 4 on at least 15 days per month. That’s not a happy group of people.

After the procedure, VAS scores were cut in half to 4.10.

30 days after the procedure, patients average VAS score had dropped to 5.25 down 36% from before the treatment. Now this is where the 88% of patients indicated that they required less or no medication for ongoing relief. 

Mandato adds "When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did…[his treatment] acts as a ‘reset button’ for the brain’s migraine circuitry.” 

Due to the safety profile of treatment, Mandato indicated the procedure can also be repeated if necessary. 

What’s next? 

The 112 patients will be tracked to see how they have responded after 6 months. Mandato is also considering a double-blind study to more rigorously evaluate the effectiveness of the treatment in treating chronic migraines.

How robust and reliable is the research?

The research is still preliminary. Which means it hasn’t gone through large clinical trials or double blind studies to take into account the effect of the placebo. There are well-cited papers that show that placebo’s can regularly deliver a 30% benefit. (3)

It is interesting to note the benefit after a month was 36%. Not miles away from what a good placebo could accomplish. This underlines the need for more robust research over a longer time frame.

Having said that, Mandato and his team should be applauded. The fact that he is working to help migraineurs makes him a friend of mine.  

The preliminary results are undeniably exciting. Getting almost 9 out of 10 people (rounding 88% up) saying that they don’t need their meds anymore one month after treatment is impressive. I’ll be waiting for his 6 months results & future studies with eager anticipation. Would you be willing to try this treatment? Let me know in the comments below.


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Sources

(1) Stout, D. 'A New Treatment For Migraine Is Showing Promising Results.' Time Magazine, March 2, 2015.

(2) Society of Interventional Radiology. (2015, March 1). 'Image-guided treatment shown to break the migraine cycle.' ScienceDaily. Retrieved March 16, 2015 from www.sciencedaily.com/releases/2015/03/150301092136.htm

(3) Brown, A. W. 'The Placebo Effect. Should Doctors Be Prescribing Sugar Pills?' Scientifc Amercian. Jan 1998. 90-95.