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GammaCore for cluster headaches

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

NICE suggest that "..Evidence supports the case for adopting gammaCore to treat cluster headache in the NHS. gammaCore reduces the frequency and intensity of cluster headache attacks and improves quality of life..." (1)

The device is CE marked and indicated for acute and preventive therapy in cluster headache (CH) and for treatment of migraine, hemicrania continua, and medication overuse headache in adults (2)

  • also approved in the United States for acute treatment of episodic CH and migraine in adults (2)
  • has demonstrated safety and efficacy for prevention and acute treatment of CH attacks in clinical trials

    Vagus nerve and use of non-vagus stimulation in cluster headaches:
  • Vagus nerve is the major parasympathetic branch of the autonomic nervous system

  • primary functions include regulation of breathing, heart rate, and digestion

  • through its afferent projections, which account for 80% of its fibers, to the brainstem's nucleus tractus solitarius (NTS), the vagus can regulate brain physiology, chemistry, plasticity, and behaviour

  • also been shown to play an important role in the regulation of the body's inflammatory responses, both centrally and peripherally, with a significant body of research elucidating an efferent, anti-inflammatory pathway mediated by acetylcholine and/or norepinephrine

  • non-invasive vagus nerve stimulation (nVNS) approaches using transcutaneous stimulation of the cervical branch of the vagus at the neck (gammaCore) or of the auricular branch of the vagus at the concha of the outer ear (Nemos), have been developed
    • gammaCore (electroCore) is a non-invasive vagus nerve stimulator used to treat and prevent cluster headaches (1)
    • self-administered by the person or their carer
    • after applying conductive gel, gammaCore is held against the neck (over the cervical branch of the vagus nerve) and delivers a small electric current for about 2 minutes
    • this stimulation should be repeated 3 times. The device is small and portable

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