Non-Invasive Cervical VNS for Headache
gammaCore for migraine and cluster headache.
What's covered
- 01Cervical nVNS device mechanics
- 02Acute & preventive migraine indications
- 03Episodic cluster headache: acute treatment
- 04Adjunctive cluster prevention
- 05Evidence variability by indication
- 06Patient counseling: realistic expectations
What this means for you
gammaCore is a handheld device you press to your neck for a couple of minutes. It's approved for certain migraines and cluster headaches and can help some people avoid or reduce medication use — but it doesn't work for everyone, and effect sizes are modest.
Indications: acute & preventive migraine (≥12y), acute episodic cluster, adjunctive cluster prevention. Effect sizes modest; consider in patients seeking non-pharm options, those with med contraindications (e.g., triptan-ineligible cardiovascular patients), or as part of multimodal regimens. Counsel on prescription/rental model and realistic expectations.
Mechanism likely involves trigeminocervical complex modulation via vagal afferents and brainstem connectivity. Trial heterogeneity (PRESTO, EVENT, ACT1/2) complicates effect-size estimates; HTAs (e.g., NICE, CADTH) note mixed certainty.