{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:01:05Z","timestamp":1787666465700,"version":"build-2736575974"},"reference-count":76,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cluster headache (CH) is a rare but severe primary headache disorder characterized by recurrent attacks of unilateral, typically periocular pain lasting 15 min to 3 h, accompanied by ipsilateral autonomic symptoms and restlessness or agitation. Attacks may occur multiple times daily and present in clusters lasting weeks to months, interspersed with remission periods in episodic CH, or without remission in chronic CH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review summarizes the clinical evidence supporting the use of transcutaneous cervical vagus nerve stimulation (tcVNS) for both the acute and preventive treatment of CH. Relevant clinical trials, real\u2010world studies, and guideline recommendations are discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pharmacological therapy for CH includes triptans and high\u2010flow oxygen for acute management, and verapamil, corticosteroids, or galcanezumab for prevention. For patients with inadequate response or intolerance to these options, neuromodulation may be required. TcVNS has emerged as a noninvasive, safe, and effective alternative to invasive neuromodulation. Clinical trials have demonstrated significant reductions in attack frequency and intensity, leading to U.S. Food and Drug Administration (FDA) clearance and UK National Institute for Health and Care Excellence (NICE) approval for both acute and preventive treatment of CH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TcVNS represents a well\u2010tolerated, noninvasive neuromodulatory option for patients with cluster headache, offering both acute and preventive benefits. This paper provides an overview of the current evidence, mechanisms of action, and practical guidelines for incorporating tcVNS into clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papr.70084","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T10:55:52Z","timestamp":1761303352000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Non\u2010Invasive Vagus Nerve Stimulation in Cluster Headache: A Clinical Practice Guideline"],"prefix":"10.1111","volume":"25","author":[{"given":"Peter J.","family":"Goadsby","sequence":"first","affiliation":[{"name":"NIHR King's Clinical Research Facility and Wolfson SPARC King's College London  London UK"},{"name":"Department of Neurology University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Feoktistov","sequence":"additional","affiliation":[{"name":"Synergy Integrative Headache Center  Chicago Illinois USA"},{"name":"American Interventional Headache Society  Bath Ohio USA"},{"name":"Neurology Department of Clinical Sciences Rosalind Franklin University of Medicine and Science  North Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Anitescu","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine University of Chicago Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miles","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Texas Tech University Health Sciences Center  Lubbock Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4079-5165","authenticated-orcid":false,"given":"Peter","family":"Staats","sequence":"additional","affiliation":[{"name":"Vagus Nerve Society  Atlantic Beach Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.11138\/fneur\/2018.33.1.057"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.6"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102418815503"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.14021"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526\u20104610.2011.02028.x"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419845660"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2024.1373528"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01220"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102420923646"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102020\u2010059577"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00535"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010018\u20103598\u20105"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419863030"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.0682"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474\u20104422(24)00143\u20101"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-018-0911-x"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/117.3.427"},{"key":"e_1_2_16_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00097-X"},{"key":"e_1_2_16_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws249"},{"key":"e_1_2_16_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004647-199902000-00001"},{"key":"e_1_2_16_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/aian.AIAN_349_17"},{"key":"e_1_2_16_24_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100042\u20101758043"},{"key":"e_1_2_16_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250505"},{"key":"e_1_2_16_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000046589.45855.30"},{"key":"e_1_2_16_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.11.nct60002"},{"key":"e_1_2_16_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000267886.85210.37"},{"key":"e_1_2_16_29_1","first-page":"1188","article-title":"Randomized Double\u2010Blind, Placebo\u2010Controlled Trial of High\u2010Flow Inhaled Oxygen in Acute Cluster Headache","volume":"27","author":"Cohen A. 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