Fuglsang CH, Johansen T, Kaila K, Kasch H, Bach FW.
Treatment of acute migraine by a partial rebreathing device: A randomized
controlled pilot study. Cephalalgia. 2018 Sep;38(10):1632-1643.
Abstract
Background Impaired brain oxygen delivery can trigger and
exacerbate migraine attacks. Normoxic hypercapnia increases brain oxygen
delivery markedly by vasodilation of the cerebral vasculature, and hypercapnia
has been shown to abort migraine attacks. Stable normoxic hypercapnia can be
induced by a compact partial rebreathing device. This pilot study aimed to
provide initial data on the device's efficacy and safety. Methods Using a
double-blinded, randomized, cross-over study design, adult migraine-with-aura
patients self-administered the partial rebreathing device or a sham device for
20 minutes at the onset of aura symptoms. Results Eleven 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%, while retaining mean oxygen saturation above 97%.
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 (-0.55 (95% CI: -1.13-0.04), p = 0.096),
whereas 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. Conclusion Normoxic hypercapnia shows promise as an
adjunctive/alternative migraine treatment, meriting further investigation in a
larger population. Clinical study registered at ClinicalTrials.gov with
identifier NCT03472417.
Courtesy of: https://www.medscape.com/viewarticle/908009?nlid=127889_3001&src=WNL_mdplsfeat_190212_mscpedit_neur&uac=60196BR&spon=26&impID=1882939&faf=1
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