[P7.177] Randomized Controlled Trial: Targeted Neck Cooling in the Treatment of the Migraine Patient

Adam S. Sprouse Blum,1,2Alexandra K. Gabriel,1Jon P. Brown,1Melvin H. c. Yee1
1Honolulu, HI, USA, 2Bronx, NY, USA


OBJECTIVE: Cold therapy has long been the number one self-care treatment employed in migraine without aura and the second most common in migraine with aura, yet its mechanism remains elusive. In this study, a mechanism by which this time-tested therapy works is proposed (by cooling the blood passing through intracranial vessels) in an attempt to further elucidate its beneficial effects.
BACKGROUND: Virtually all studies evaluating cold therapy in the treatment of migraine show benefit. However, they all target the same location...the head. This makes sense, because this is where it hurts. However, cold applied to the head must penetrate through the skull to get to the target vessels on the inside. As such, we utilized a strategy employed by marathon runners. That is, targeting locations where large blood vessels come close to the skin surface. In our case, the carotid arteries at the neck.
DESIGN/METHODS: The study is designed as a randomized, controlled, crossover clinical trial utilizing an adjustable neck wrap containing two freezable ice packs targeting the carotid arteries at the front of the neck. Participants served as their own control, trialing the wrap both frozen and room temperature at migraine onset and recording their pain on a visual analog scale at fixed intervals.
RESULTS: 55 participants successfully completed the study. Pain at onset was similar between the two treatment arms. Maximum pain reduction was observed at the 30 minute time point with a 31.8% +/- 15.2% decrease in pain in the treatment arm compared to a 31.5% +/- 20.0% increase in pain at the same time interval in the control arm.
CONCLUSIONS: These findings confirm the application of a frozen neck wrap targeting the carotid arteries at the neck significantly reduced recorded pain in participants with migraine headaches (p < 0.001).
Study Supported by: N/A
Category - Headache: Therapeutics

Thursday, May 1, 2014 3:00 PM

P7: Poster Session VII: Headache: Treatment (3:00 PM-6:30 PM)

 

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