{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:57:49Z","timestamp":1789837069144,"version":"4.0.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"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:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Migraine is a chronic neurological disease manifesting as attacks of disabling head pain and associated symptoms. Remote electrical neuromodulation (REN) is a non-pharmacological, prescribed, wearable device (Nerivio\u00ae). This device has been certified by the FDA for the acute and\/or preventive treatment of migraine with or without aura in patients 12 years of age or older. The device is affixed to the user\u2019s arm during 45-min treatment sessions and is operated using a smartphone app. This study (NCT05769322) aims to evaluate whether frequent use of REN for the acute treatment of migraine in adolescents resulted in a reduction in monthly migraine treatment days (MMTD), as previously demonstrated in adults through a dedicated prevention clinical trial (NCT04828707).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included real-world prospective data from adolescent patients who used REN on at least 10 days every 28-day month, following the REN migraine prevention guideline of an every-other-day pattern. Additional requirements were at least three REN treatment days in each of the two subsequent months. The number of MMTD was used as a proxy measure for the number of monthly migraine days (MMD). The change in MMTD from the first month, taken as a \u201cbaseline,\u201d to each of the following months was used to evaluate the presence and size of potential migraine preventive benefits of REN in adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 83 adolescents were eligible for analysis. The users were 15.9\u2009\u00b1\u20091.3 years of age (mean\u2009\u00b1\u2009SD), and 89% of them were female. The results demonstrated a substantial month-to-month reduction in the mean (\u00b1SD) number of REN treatment days from 12.6 (\u00b13.2) MMTD in the first month to 9.0 (\u00b14.8) MMTD in the second month (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and a further decrease to 7.4 (\u00b14.2) MMTD in the third month (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). This indicates an accumulative reduction of 5.2 (\u00b14.8) mean REN MMTD from the first month to the third month of consecutive REN treatment. The users also reported consistent 2-h acute pain responses in at least 50% of their treated attacks, with 61.9% of the users reported experiencing pain relief, 24.5% reported pain freedom, 67.4% indicated relief in functional disability, and 41.3% reported complete freedom from functional disability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The frequent use of REN among adolescents as an acute treatment for migraine attacks resulted in a decrease in the mean number of monthly treatment days in the subsequent months, suggesting that REN may have potential preventive benefits for migraine in this subpopulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpain.2023.1247313","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T04:58:49Z","timestamp":1699246729000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":23,"title":["Remote electrical neuromodulation (REN) wearable device for adolescents with migraine: a real-world study of high-frequency abortive treatment suggests preventive effects"],"prefix":"10.3389","volume":"4","author":[{"given":"Teshamae S.","family":"Monteith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alit","family":"Stark-Inbar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Shmuely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagan","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"Garas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Ironi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Kalika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha L.","family":"Irwin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1177\/0333102413485658","article-title":"The International Classification of Headache Disorders, 3rd edition (beta version)","volume":"33","year":"2013","journal-title":"Cephalalgia"},{"key":"B2","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1212\/WNL.0000000000008095","article-title":"Practice guideline update summary: acute treatment of migraine in children and adolescents: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology and the American Headache Society","volume":"93","author":"Oskoui","year":"2019","journal-title":"Neurology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1111\/head.13091","article-title":"Migraine in children","volume":"57","author":"Tepper","year":"2017","journal-title":"Headache"},{"key":"B4","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s11916-013-0341-z","article-title":"Epidemiology of migraine and headache in children and adolescents","volume":"17","author":"W\u00f6ber-Bing\u00f6l","year":"2013","journal-title":"Curr Pain Headache Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/1129-2377-15-60","article-title":"Risk factors for migraine and tension-type headache in 11 year old children","volume":"15","author":"Waldie","year":"2014","journal-title":"J Headache Pain"},{"key":"B6","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s11910-021-01128-9","article-title":"Approach to pediatric intractable migraine","volume":"21","author":"Alqahtani","year":"2021","journal-title":"Curr Neurol Neurosci Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1542\/peds.112.1.e1","article-title":"Quality of life in childhood migraines: clinical impact and comparison to other chronic illnesses","volume":"112","author":"Powers","year":"2003","journal-title":"Pediatrics"},{"key":"B8","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1080\/17434440.2023.2202815","article-title":"Device profile of Nerivio for the acute and preventive treatment of episodic or chronic migraine in patients 12 years and older","volume":"20","author":"Babaei","year":"2023","journal-title":"Expert Rev Med Devices"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1111\/head.13551","article-title":"Remote electrical neuromodulation (REN) relieves acute migraine: a randomized, double-blind, placebo-controlled, multicenter trial","volume":"59","author":"Yarnitsky","year":"2019","journal-title":"Headache"},{"key":"B10","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1111\/head.14469","article-title":"Remote electrical neuromodulation for migraine prevention: a double-blind, randomized, placebo-controlled clinical trial","volume":"63","author":"Tepper","year":"2023","journal-title":"Headache"},{"key":"B11","doi-asserted-by":"publisher","first-page":"267","DOI":"10.2217\/PMT-2021-0038","article-title":"Nerivio\u00ae remote electrical neuromodulation for acute treatment of chronic migraine","volume":"12","author":"Nierenburg","year":"2022","journal-title":"Pain Manag"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e966","DOI":"10.1097\/PR9.0000000000000966","article-title":"Safety and efficacy of remote electrical neuromodulation for the acute treatment of chronic migraine: an open-label study","volume":"6","author":"Grosberg","year":"2021","journal-title":"Pain Rep"},{"key":"B13","doi-asserted-by":"publisher","first-page":"753736","DOI":"10.3389\/fpain.2021.753736","article-title":"Real-world analysis of remote electrical neuromodulation (REN) for the acute treatment of migraine","volume":"2","author":"Ailani","year":"2022","journal-title":"Front Pain Res (Lausanne)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1007\/s40122-021-00276-7","article-title":"Remote electrical neuromodulation (REN) for the acute treatment of menstrual migraine: a retrospective survey study of effectiveness and tolerability","volume":"10","author":"Nierenburg","year":"2021","journal-title":"Pain Ther"},{"key":"B15","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1111\/head.14042","article-title":"Remote electrical neuromodulation for acute treatment of migraine in adolescents","volume":"61","author":"Hershey","year":"2021","journal-title":"Headache"},{"key":"B16","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.pediatrneurol.2023.02.008","article-title":"Acute treatment of migraine in adolescents: real-world analysis of remote electrical neuromodulation (REN)","volume":"142","author":"Esparham","year":"2023","journal-title":"Pediatr Neurol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1001\/jamapediatrics.2019.5856","article-title":"Efficacy, safety, and acceptability of pharmacologic treatments for pediatric migraine prophylaxis: a systematic review and network meta-analysis","volume":"174","author":"Locher","year":"2020","journal-title":"JAMA Pediatr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1093\/pm\/pnab197","article-title":"Comparison of remote electrical neuromodulation (REN) and standard-care medications for acute treatment of migraine in adolescents: a post-hoc analysis","volume":"23","author":"Hershey","year":"2022","journal-title":"Pain Medicine"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1212\/WNL.0000000000003760","article-title":"Nonpainful remote electrical stimulation alleviates episodic migraine pain","volume":"88","author":"Yarnitsky","year":"2017","journal-title":"Neurology"},{"key":"B20","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1097\/SPC.0000000000000126","article-title":"Conditioned pain modulation","volume":"9","author":"Nir","year":"2015","journal-title":"Curr Opin Support Palliat Care"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1111\/j.1526-4610.2005.00262.x","article-title":"Topiramate for migraine prevention in children: a randomized, double-blind, placebo-controlled trial","volume":"45","author":"Winner","year":"2005","journal-title":"Headache"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1111\/head.12836","article-title":"Adherence to biobehavioral recommendations in pediatric migraine as measured by electronic monitoring: the adherence in migraine (AIM) study","volume":"56","author":"Van Diest","year":"2016","journal-title":"Headache"},{"key":"B23","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1111\/j.1533-2500.2012.00530.x","article-title":"Adherence with migraine prophylaxis in clinical practice","volume":"12","author":"Berger","year":"2012","journal-title":"Pain Pract"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2035","DOI":"10.1177\/0333102418756864","article-title":"A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine","volume":"38","author":"Ramsey","year":"2018","journal-title":"Cephalalgia"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1542\/peds.2009-1953","article-title":"Policy statement\u2014guidance for the administration of medication in school","volume":"124","year":"2009","journal-title":"Pediatrics"},{"key":"B26","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1212\/01.CON.0000418644.32032.7b","article-title":"Medication-overuse headache","volume":"18","author":"Tepper","year":"2012","journal-title":"Continuum"},{"key":"B27","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1212\/WNL.0000000000001256","article-title":"Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine","volume":"84","author":"Lipton","year":"2015","journal-title":"Neurology"},{"key":"B28","year":""},{"key":"B29","year":""},{"key":"B30","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1111\/head.13284","article-title":"Transcranial magnetic stimulation for migraine prevention in adolescents: a pilot open-label study","volume":"58","author":"Irwin","year":"2018","journal-title":"Headache"},{"key":"B31","year":""},{"key":"B32","author":"Atske","year":""},{"key":"B33","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/1129-2377-14-79","article-title":"Headache and comorbidity in children and adolescents","volume":"14","author":"Bellini","year":"2013","journal-title":"J Headache Pain"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1111\/head.14153","article-title":"Board of directors of the American Headache Society. The American Headache Society consensus statement: update on integrating new migraine treatments into clinical practice","volume":"61","author":"Ailani","year":"2021","journal-title":"Headache"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1093\/pm\/pnac021","article-title":"Combining guided intervention of education and relaxation (GIER) with remote electrical neuromodulation (REN) in the acute treatment of migraine","volume":"23","author":"Buse","year":"2022","journal-title":"Pain Med"},{"key":"B36","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1177\/0333102418776018","article-title":"Cephalic cutaneous allodynia in children and adolescents with migraine of short duration: a retrospective cohort study","volume":"39","author":"Levinsky","year":"2019","journal-title":"Cephalalgia"},{"key":"B37","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1080\/13696998.2023.2205751","article-title":"Clinical benefits and economic cost-savings of remote electrical neuromodulation (REN) for migraine prevention","volume":"26","author":"Cowan","year":"2023","journal-title":"J Med Econ"},{"key":"B38","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1177\/0333102414552532","article-title":"The impact of chronic migraine: the chronic migraine epidemiology and outcomes (CaMEO) study methods and baseline results","volume":"35","author":"Adams","year":"2015","journal-title":"Cephalalgia"},{"key":"B39","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/S0304-3959(03)00293-8","article-title":"Factors associated with the onset and remission of chronic daily headache in a population-based study","volume":"106","author":"Scher","year":"2003","journal-title":"Pain"},{"key":"B40","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1002\/1531-8249(200005)47:5%3C614::AID-ANA9%3E3.0.CO;2-N","article-title":"An association between migraine and cutaneous allodynia","volume":"47","author":"Burstein","year":"2000","journal-title":"Ann Neurol"}],"container-title":["Frontiers in Pain Research"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2023.1247313\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T04:58:51Z","timestamp":1699246731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2023.1247313\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,6]]},"references-count":40,"alternative-id":["10.3389\/fpain.2023.1247313"],"URL":"https:\/\/doi.org\/10.3389\/fpain.2023.1247313","relation":{},"ISSN":["2673-561X"],"issn-type":[{"value":"2673-561X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,6]]},"article-number":"1247313"}}