Long-Term Efficacy of Occipital Nerve Stimulation for Medically Intractable Cluster Headache
Aurélie Leplus
(1)
,
Denys Fontaine
(1)
,
Anne Donnet
(2, 3)
,
Jean Regis
(4, 2)
,
Christian Lucas
(5)
,
Nadia Buisset
,
Serge Blond
(6)
,
Sylvie Raoul
(7)
,
Evelyne Guegan-Massardier
(8)
,
Stéphane Derrey
(9, 10, 11, 12, 13)
,
Bechir Jarraya
(14)
,
Bich Dang-Vu
(15)
,
Frederic Bourdain
(16)
,
Dominique Valade
(17)
,
Caroline Roos
(18)
,
Christelle Creach
(19)
,
Stéphan Chabardes
(20)
,
Pierric Giraud
(21)
,
Jimmy Voirin
(22)
,
Jocelyne Bloch
(23)
,
Sophie Colnat-Coulbois
,
François Caire
(24, 25)
,
Philippe Rigoard
,
Laurie Tran
,
Coralie Cruzel
,
Michel Lantéri-Minet
1
CHU Nice -
Centre Hospitalier Universitaire de Nice
2 TIMONE - Hôpital de la Timone [CHU - APHM]
3 Neuro-Dol - Neuro-Dol
4 INS - Institut de Neurosciences des Systèmes
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 Département de neurologie [Lille]
7 CHU Nantes - Centre Hospitalier Universitaire de Nantes
8 CHU Rouen
9 Service de Neurochirurgie [CHU Rouen]
10 ADEN - Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau
11 IRIB - Institute for Research and Innovation in Biomedicine
12 CIC Rouen - Centre d'Investigation Clinique [CHU Rouen]
13 UNIROUEN UFR Santé - UNIROUEN - UFR Santé
14 NEUROSPIN - Service NEUROSPIN
15 Department of Neuroradiology, Foch Hospital, Suresnes, France
16 Neurologie - Côte Basque
17 CHU Pitié-Salpêtrière [AP-HP]
18 Hôpital Lariboisière-Fernand-Widal [APHP]
19 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
20 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
21 Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
22 ICube - Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie
23 School of Life Sciences [Lausanne]
24 XLIM - XLIM
25 CHU Limoges
2 TIMONE - Hôpital de la Timone [CHU - APHM]
3 Neuro-Dol - Neuro-Dol
4 INS - Institut de Neurosciences des Systèmes
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 Département de neurologie [Lille]
7 CHU Nantes - Centre Hospitalier Universitaire de Nantes
8 CHU Rouen
9 Service de Neurochirurgie [CHU Rouen]
10 ADEN - Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau
11 IRIB - Institute for Research and Innovation in Biomedicine
12 CIC Rouen - Centre d'Investigation Clinique [CHU Rouen]
13 UNIROUEN UFR Santé - UNIROUEN - UFR Santé
14 NEUROSPIN - Service NEUROSPIN
15 Department of Neuroradiology, Foch Hospital, Suresnes, France
16 Neurologie - Côte Basque
17 CHU Pitié-Salpêtrière [AP-HP]
18 Hôpital Lariboisière-Fernand-Widal [APHP]
19 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
20 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
21 Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
22 ICube - Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie
23 School of Life Sciences [Lausanne]
24 XLIM - XLIM
25 CHU Limoges
Nadia Buisset
- Fonction : Auteur
Sophie Colnat-Coulbois
- Fonction : Auteur
- PersonId : 786933
- ORCID : 0000-0003-1987-857X
- IdRef : 096245859
Philippe Rigoard
- Fonction : Auteur
Laurie Tran
- Fonction : Auteur
Coralie Cruzel
- Fonction : Auteur
Michel Lantéri-Minet
- Fonction : Auteur
Résumé
Abstract BACKGROUND Occipital nerve stimulation (ONS) has been proposed to treat refractory chronic cluster headache (rCCH) but its efficacy has only been showed in small short-term series. OBJECTIVE To evaluate ONS long-term efficacy in rCCH. METHODS We studied 105 patients with rCCH, treated by ONS within a multicenter ONS prospective registry. Efficacy was evaluated by frequency, intensity of pain attacks, quality of life (QoL) EuroQol 5 dimensions (EQ5D), functional (Headache Impact Test-6, Migraine Disability Assessment) and emotional (Hospital Anxiety Depression Scale [HAD]) impacts, and medication consumption. RESULTS At last follow-up (mean 43.8 mo), attack frequency was reduced >50% in 69% of the patients. Mean weekly attack frequency decreased from 22.5 at baseline to 9.9 ( P < .001) after ONS. Preventive and abortive medications were significantly decreased. Functional impact, anxiety, and QoL significantly improved after ONS. In excellent responders (59% of the patients), attack frequency decreased by 80% and QoL (EQ5D visual analog scale) dramatically improved from 37.8/100 to 73.2/100. When comparing baseline and 1-yr and last follow-up outcomes, efficacy was sustained over time. In multivariable analysis, low preoperative HAD-depression score was correlated to a higher risk of ONS failure. During the follow-up, 67 patients experienced at least one complication, 29 requiring an additional surgery: infection (6%), lead migration (12%) or fracture (4.5%), hardware dysfunction (8.2%), and local pain (20%). CONCLUSION Our results showed that long-term efficacy of ONS in CCH was maintained over time. In responders, ONS induced a major reduction of functional and emotional headache-related impacts and a dramatic improvement of QoL. These results obtained in real-life conditions support its use and dissemination in rCCH patients.