Pilot Study Showcases Breathing Device for Acute Migraine

By Dorothy L. Tengler via Multibriefs

Migraine is the third most prevalent neurological disease in the world, affecting 39 million men, women, and children in the United States and 1 billion people worldwide. In the U.S., nearly 1 in 4 households includes someone who suffers with migraine.

A 2012 report by the National Center for Health Statistics noted that 16 percent of U.S. adults 18 or older reported having migraine or severe headaches in the previous three months. Migraine is most common between the ages of 25 and 55 years and tends to run in families.

About 90 percent of sufferers have a family history of migraine. Migraine is more prevalent in women (18 percent) than men (6 percent). In fact, migraine is one of the leading serious health problems affecting women.

Chronic migraine headaches are classified as either common (nausea, dizziness, fever, and general malaise), or classical, known for its preceding aura. The classical migraine headache is characterized by a relatively short duration (less than or equal to 12 hours) compared with the common migraine headache (up to 4 days).

Treatment has included both pain-relieving and preventative medications. Many patients attend pain clinics and endure countless trials of different medications. For some, the medications work for a short time, others not at all.

According to a new study, however, some migraine patients may be able to cut down on medication or stop taking medication at all by using a newly developed inhaler that changes the composition of the air that they breathe.

According to one of the authors, Troels Johansen, who carried out the study as part of his Ph.D. at the Department of Clinical Medicine at Aarhus University and the Headache Clinic at Aarhus University Hospital in Denmark, migraines occur as part of a chain reaction during which the veins in the brain contract, and the blood cannot therefore supply the brain with enough oxygen.

The researchers used CO2 and oxygen, the body's natural molecules for mobilizing its own defense against migraine attacks. The inhaler expands the blood vessels that supply the brain with oxygen by up to 70 per cent, which stops the destructive chain reaction. The treatment starts after a few seconds.

Using a double-blind, randomized, cross-over study design, 11 participants (mean age 35.5, three men) self-treated 41 migraine attacks (20 with the partial rebreathing device, 21 with sham). The partial rebreathing device increased mean End Tidal CO2 by 24 percent, while retaining mean oxygen saturation above 97 percent.

The primary end point (headache intensity difference between first aura symptoms and two hours after treatment [0-3 scale] – active/sham difference) did not reach statistical significance (p = 0.096). The difference in percentage of attacks with pain relief at two hours was significant (p = 0.043) as was user satisfaction (p = 0.022).

A marked efficacy increase was seen from first to second time use of the partial rebreathing device. No adverse events occurred, and side effects were absent or mild.

The study shows some very significant physiological effects in the body. Johansen is now planning to conduct a large clinical trial that will also include migraine without aura and chronic migraine.

Dorothy L. Tengler, MA, is a freelance medical writer/communication specialist with nearly 20 years of experience in the pharmaceutical and medical communication industries. She has developed educational and medical marketing materials, including monographs, slide kits, health articles, primary and review manuscripts, and pharmaceutical sales training materials.