Primary headache disorders, such as migraine, cluster headache and tension-type headache, are among the most common diseases and leading causes of disability worldwide. The available treatment options for primary headache disorders have unsatisfactory rates of efficacy, tolerability and patient adherence. In this review, Schuster and Rapoport discuss new approaches for the prevention of primary headache disorders, such as monoclonal antibodies targeting calcitonin gene-related peptide or its receptor, and their small-molecule receptor antagonists. Neuromodulation approaches employing noninvasive or implantable devices have been developed which also show promise. Transcranial magnetic stimulation and transcutaneous peripheral nerve stimulation, for example, are delivered by devices that patients can self-administer. Implantable devices targeting the occipital nerves, sphenopalatine ganglion or high cervical spinal cord are also presented. The authors discuss how these new and emerging treatments have the potential to address unmet patient needs and reduce headache-associated disability..
Schuster NM and Rapoport AM: New strategies for the treatment and prevention of primary headache disorders. Nature Reviews Neurology 12: 635–650 (2016); doi:10.1038/nrneurol.2016.143..