{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:14:58Z","timestamp":1782515698851,"version":"3.54.5"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:p>Primary headache disorders can be remarkably disabling and the therapeutic options available are usually limited to medication with a high rate of adverse events. Here, we discuss the mechanism of action of non-invasive vagal nerve stimulation, as well as the findings of the main studies involving patients with primary headaches other than migraine or cluster headache, such as hemicrania continua, paroxysmal hemicrania, cough headache, or short-lasting neuralgiform headache attacks (SUNCT\/SUNA), in a narrative analysis. A bibliographical search of low-prevalence disorders such as rare primary headaches retrieves a moderate number of studies, usually underpowered. Headache intensity, severity, and duration showed a clinically significant reduction in the majority, especially those involving indomethacin-responsive headaches. The lack of response of some patients with a similar diagnosis could be due to a different stimulation pattern, technique, or total dose. The use of non-invasive vagal nerve stimulation for the treatment of primary headache disorders represents an excellent option for patients with these debilitating and otherwise refractory conditions, or that cannot tolerate several lines of preventive medication, and should always be considered before contemplating invasive, non-reversible stimulation techniques.<\/jats:p>","DOI":"10.3389\/fpain.2023.1062892","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T05:49:17Z","timestamp":1678686557000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Non-invasive neuromodulation of the cervical vagus nerve in rare primary headaches"],"prefix":"10.3389","volume":"4","author":[{"given":"Maria Dolores","family":"Villar-Martinez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Goadsby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"The international classification of headache disorders, 3rd edition","volume":"38","year":"2018","journal-title":"Cephalalgia"},{"key":"B2","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1111\/head.14111","article-title":"Indomethacin-responsive headaches\u2014a narrative review","volume":"61","author":"Villar-Martinez","year":"2021","journal-title":"Headache"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S40","DOI":"10.1111\/j.1528-1157.1990.tb05848.x","article-title":"Prevention of intractable partial seizures by intermittent vagal stimulation in humans: preliminary results","volume":"31","author":"Penry","year":"1990","journal-title":"Epilepsia"},{"key":"B4","doi-asserted-by":"publisher","first-page":"S7","DOI":"10.1111\/j.1528-1157.1990.tb05852.x","article-title":"Effects of vagal stimulation on experimentally induced seizures in rats","volume":"31","author":"Woodbury","year":"1990","journal-title":"Epilepsia"},{"key":"B5","unstructured":""},{"key":"B6","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/0013-4694(52)90064-3","article-title":"The effect of vagal afferent stimulation on the EEG pattern of the cat","volume":"4","author":"Zanchetti","year":"1952","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1097\/00004647-200110000-00005","article-title":"Magnetic resonance angiography in facial and other pain: neurovascular mechanisms of trigeminal sensation","volume":"21","author":"May","year":"2001","journal-title":"J Cereb Blood Flow Metab"},{"key":"B8","doi-asserted-by":"publisher","first-page":"A62","DOI":"10.1186\/1129-2377-16-S1-A62","article-title":"P038. 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