Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysis
Abstract Background Migraine is a disabling disorder characterized by recurrent severe headache attacks. Non-invasive neuromodulation can be employed in the prevention and/or acute treatment of migraine. Remote electrical neuromodulation (REN), a type of non-invasive neuromodulation, is an effective...
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2025-08-01
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| Online Access: | https://doi.org/10.1186/s12883-025-04291-5 |
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| author | Asmaa Zakria Alnajjar Mohamed M. M. Mustafa Omar Khaled Abdelsalam Israa Sharabati Amr K. Hassan Meran Allam Moaz Elsayed Abouelmagd |
| author_facet | Asmaa Zakria Alnajjar Mohamed M. M. Mustafa Omar Khaled Abdelsalam Israa Sharabati Amr K. Hassan Meran Allam Moaz Elsayed Abouelmagd |
| author_sort | Asmaa Zakria Alnajjar |
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| description | Abstract Background Migraine is a disabling disorder characterized by recurrent severe headache attacks. Non-invasive neuromodulation can be employed in the prevention and/or acute treatment of migraine. Remote electrical neuromodulation (REN), a type of non-invasive neuromodulation, is an effective and safe at-home treatment for migraine. It stimulates peripheral nerves in the upper arm to trigger conditioned pain modulation. Methods We searched PubMed, Web of Science, Scopus, and the Cochrane Library for clinical trials and observational studies that assess the efficacy of REN in patients with migraine attacks. Statistical analysis was performed using Review Manager version 5.4.1 and Open Meta Analyst software. Results Our study included 12 studies with 9912 migraine patients. In the single-arm meta-analysis, 64% (95% CI: 0.62 to 0.65), and 22% (95% CI: 0.213 to 0.237) of patients experienced a reduction in pain and pain-free status at 2 h, respectively. Additionally, 59% (95% CI: 0.548 to 0.637), and 54% (95% CI: 0.471 to 0.609) of patients reported sustained pain relief and sustained pain-free status at 24 h, respectively. Marked functional improvement was achieved in 59% (95% CI: 0.577–0.607) of patients within 2 h post-treatment with REN, and 54.6% (95% CI: [0.519 to 0.574]) reported the disappearance of their most bothersome symptom (MBS). Device-related adverse events were reported in 0.4% (95% CI: 0.003 to 0.005) of patients. In double arm meta-analysis, pain-free status at 2 h had an odds ratio (OR) of 2.77 (95% CI: 1.63 to 4.71). While device-related adverse events had an OR of 1.45 (95%CI: 0.42 to 4.94). Trial registration CRD42024596712 |
| format | Article |
| id | doaj-art-c320a816fc5c4795b3a092b50163602d |
| institution | Kabale University |
| issn | 1471-2377 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj-art-c320a816fc5c4795b3a092b50163602d2025-08-20T03:43:16ZengBMCBMC Neurology1471-23772025-08-0125111310.1186/s12883-025-04291-5Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysisAsmaa Zakria Alnajjar0Mohamed M. M. Mustafa1Omar Khaled Abdelsalam2Israa Sharabati3Amr K. Hassan4Meran Allam5Moaz Elsayed Abouelmagd6Faculty of Medicine, Al-Azhar UniversityFaculty of Pharmacy, Egyptian Russian UniversityFaculty of Medicine, New Mansoura UniversityFaculty of Medicine, Al-Quds UniversityDepartment of Ophthalmology, School of Medicine, University of CaliforniaEgyptian ministry of health, Winget hospitalFaculty of Medicine, Cairo UniversityAbstract Background Migraine is a disabling disorder characterized by recurrent severe headache attacks. Non-invasive neuromodulation can be employed in the prevention and/or acute treatment of migraine. Remote electrical neuromodulation (REN), a type of non-invasive neuromodulation, is an effective and safe at-home treatment for migraine. It stimulates peripheral nerves in the upper arm to trigger conditioned pain modulation. Methods We searched PubMed, Web of Science, Scopus, and the Cochrane Library for clinical trials and observational studies that assess the efficacy of REN in patients with migraine attacks. Statistical analysis was performed using Review Manager version 5.4.1 and Open Meta Analyst software. Results Our study included 12 studies with 9912 migraine patients. In the single-arm meta-analysis, 64% (95% CI: 0.62 to 0.65), and 22% (95% CI: 0.213 to 0.237) of patients experienced a reduction in pain and pain-free status at 2 h, respectively. Additionally, 59% (95% CI: 0.548 to 0.637), and 54% (95% CI: 0.471 to 0.609) of patients reported sustained pain relief and sustained pain-free status at 24 h, respectively. Marked functional improvement was achieved in 59% (95% CI: 0.577–0.607) of patients within 2 h post-treatment with REN, and 54.6% (95% CI: [0.519 to 0.574]) reported the disappearance of their most bothersome symptom (MBS). Device-related adverse events were reported in 0.4% (95% CI: 0.003 to 0.005) of patients. In double arm meta-analysis, pain-free status at 2 h had an odds ratio (OR) of 2.77 (95% CI: 1.63 to 4.71). While device-related adverse events had an OR of 1.45 (95%CI: 0.42 to 4.94). Trial registration CRD42024596712https://doi.org/10.1186/s12883-025-04291-5MigraineRemote electrical neuromodulationRENConditioned pain modulation |
| spellingShingle | Asmaa Zakria Alnajjar Mohamed M. M. Mustafa Omar Khaled Abdelsalam Israa Sharabati Amr K. Hassan Meran Allam Moaz Elsayed Abouelmagd Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysis BMC Neurology Migraine Remote electrical neuromodulation REN Conditioned pain modulation |
| title | Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysis |
| title_full | Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysis |
| title_short | Efficacy and safety of remote electrical neuromodulation in migraine: a comprehensive systematic review and meta-analysis |
| title_sort | efficacy and safety of remote electrical neuromodulation in migraine a comprehensive systematic review and meta analysis |
| topic | Migraine Remote electrical neuromodulation REN Conditioned pain modulation |
| url | https://doi.org/10.1186/s12883-025-04291-5 |
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