{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:36:51Z","timestamp":1785317811343,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of the Child Neurology Society"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Migraine is a prevalent neurological disorder severely impacting children and adolescents, yet only one pharmacological treatment is approved for ages 6\u221212 years. Remote electrical neuromodulation (REN) is a nonpharmacological, prescribed, wearable device cleared by the Food and Drug Administration\u00a0for acute and\/or preventive treatment of migraine with or without aura in patients 12 years and older. This study evaluates REN's safety and efficacy in ages 6\u221211 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective acute treatment of migraine data were collected through the REN device (Nerivio) smartphone application. Endpoints were device safety (primary);\u00a0consistent treatment efficacy (headache pain, functional disability, associated migraine symptoms), and REN\u2010medication combinations 2\u2009h\u00a0post\u2010treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Children (<jats:italic>n<\/jats:italic>\u2009=\u2009293), median age 11 years (interquartile range\u2009=\u20099\u221211), 73.7% girls, conducted 5493 REN treatments. No adverse events were reported. Efficacy in at least 50% of REN treatments was calculated from all patients who voluntarily reported pain levels, symptoms, and\/or disability at treatment onset and at 2\u2009h\u00a0post\u2010treatment, with 72.2% (13\/18) of patients reporting pain relief, 36.0% (9\/25) pain freedom, 83.3% (15\/18) functional disability relief, and 38.9% (7\/18) functional disability freedom. Migraine\u2010associated symptoms disappeared in at least 50% of REN treatments in 70.0% (7\/10) of patients for nausea\/vomiting, 50.0% (4\/8) phonophobia, and 22.2% (2\/9) photophobia; 63.6% (7\/11) reported freedom from at least one associated symptom. REN was used as a standalone treatment, with over\u2010the\u2010counter medications, and with prescribed headache medications in 45.4%, 34.4%, and 20.9% of treatments, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>REN may serve as a safe and efficacious acute treatment of migraine for children. Providers and families seeking a safe, effective, pill\u2010 and needle\u2010free treatment option for children suffering from migraine may consider REN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cns3.20073","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T09:14:45Z","timestamp":1716282885000},"page":"135-145","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Acute treatment of migraine in children aged 6\u221211: Real\u2010world analysis of remote electrical neuromodulation (REN)"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9314-8076","authenticated-orcid":false,"given":"Klaus","family":"Werner","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurology Duke University Medical Center  Durham North Carolina 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