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Occipital nerve stimulation in medically intractable, chronic cluster headache, the ICON study: rationale and protocol of a randomised trial

(2013) CEPHALALGIA. 33(15). p.1238-1247
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Abstract
Background: About 10% of cluster headache patients have the chronic form. At least 10% of this chronic group is intractable to or cannot tolerate medical treatment. Open pilot studies suggest that occipital nerve stimulation (ONS) might offer effective prevention in these patients. Controlled neuromodulation studies in treatments inducing paraesthesias have a general problem in blinding. We have introduced a new design in pain neuromodulation by which we think we can overcome this problem. Methods/design: We propose a prospective, randomised, double-blind, parallel-group international clinical study in medically intractable, chronic cluster headache patients of high- versus low-amplitude ONS. Primary outcome measure is the mean number of attacks over the last four weeks. After a study period of six months there is an open extension phase of six months. Alongside the randomised trial an economic evaluation study is performed. Discussion: The ICON study will show if ONS is an effective preventive therapy for patients suffering medically intractable chronic cluster headache and if there is a difference between high- and low-amplitude stimulation. The innovative design of the study will, for the first time, assess efficacy of ONS in a blinded way.
Keywords
occipital nerve stimulation, Cluster headache, ICON study, chronic cluster headache, study protocol, Trial registration: Clinical trials, gov NCT01151631, COST-EFFECTIVENESS ANALYSIS, EFFICACY, SUMATRIPTAN, MANAGEMENT, SAFETY, GRAY, PET

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Citation

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MLA
Wilbrink, Leopoldine A, Onno PM Teernstra, Joost Haan, et al. “Occipital Nerve Stimulation in Medically Intractable, Chronic Cluster Headache, the ICON Study: Rationale and Protocol of a Randomised Trial.” CEPHALALGIA 33.15 (2013): 1238–1247. Print.
APA
Wilbrink, L. A., Teernstra, O. P., Haan, J., van Zwet, E. W., Evers, S. M., Spincemaille, G. H., Veltink, P. H., et al. (2013). Occipital nerve stimulation in medically intractable, chronic cluster headache, the ICON study: rationale and protocol of a randomised trial. CEPHALALGIA, 33(15), 1238–1247.
Chicago author-date
Wilbrink, Leopoldine A, Onno PM Teernstra, Joost Haan, Erik W van Zwet, Silvia MAA Evers, Geert H Spincemaille, Peter H Veltink, et al. 2013. “Occipital Nerve Stimulation in Medically Intractable, Chronic Cluster Headache, the ICON Study: Rationale and Protocol of a Randomised Trial.” Cephalalgia 33 (15): 1238–1247.
Chicago author-date (all authors)
Wilbrink, Leopoldine A, Onno PM Teernstra, Joost Haan, Erik W van Zwet, Silvia MAA Evers, Geert H Spincemaille, Peter H Veltink, Wim Mulleners, Ronald Brand, Frank JPM Huygen, Rigmor H Jensen, Koen Paemeleire, Peter J Goadsby, Veerle Visser-Vandewalle, and Michel D Ferrari. 2013. “Occipital Nerve Stimulation in Medically Intractable, Chronic Cluster Headache, the ICON Study: Rationale and Protocol of a Randomised Trial.” Cephalalgia 33 (15): 1238–1247.
Vancouver
1.
Wilbrink LA, Teernstra OP, Haan J, van Zwet EW, Evers SM, Spincemaille GH, et al. Occipital nerve stimulation in medically intractable, chronic cluster headache, the ICON study: rationale and protocol of a randomised trial. CEPHALALGIA. 2013;33(15):1238–47.
IEEE
[1]
L. A. Wilbrink et al., “Occipital nerve stimulation in medically intractable, chronic cluster headache, the ICON study: rationale and protocol of a randomised trial,” CEPHALALGIA, vol. 33, no. 15, pp. 1238–1247, 2013.
@article{4084237,
  abstract     = {Background: About 10% of cluster headache patients have the chronic form. At least 10% of this chronic group is intractable to or cannot tolerate medical treatment. Open pilot studies suggest that occipital nerve stimulation (ONS) might offer effective prevention in these patients. Controlled neuromodulation studies in treatments inducing paraesthesias have a general problem in blinding. We have introduced a new design in pain neuromodulation by which we think we can overcome this problem. 
Methods/design: We propose a prospective, randomised, double-blind, parallel-group international clinical study in medically intractable, chronic cluster headache patients of high- versus low-amplitude ONS. Primary outcome measure is the mean number of attacks over the last four weeks. After a study period of six months there is an open extension phase of six months. Alongside the randomised trial an economic evaluation study is performed. 
Discussion: The ICON study will show if ONS is an effective preventive therapy for patients suffering medically intractable chronic cluster headache and if there is a difference between high- and low-amplitude stimulation. The innovative design of the study will, for the first time, assess efficacy of ONS in a blinded way.},
  author       = {Wilbrink, Leopoldine A and Teernstra, Onno PM and Haan, Joost and van Zwet, Erik W and Evers, Silvia MAA and Spincemaille, Geert H and Veltink, Peter H and Mulleners, Wim and Brand, Ronald and Huygen, Frank JPM and Jensen, Rigmor H and Paemeleire, Koen and Goadsby, Peter J and Visser-Vandewalle, Veerle and Ferrari, Michel D},
  issn         = {0333-1024},
  journal      = {CEPHALALGIA},
  keywords     = {occipital nerve stimulation,Cluster headache,ICON study,chronic cluster headache,study protocol,Trial registration: Clinical trials,gov NCT01151631,COST-EFFECTIVENESS ANALYSIS,EFFICACY,SUMATRIPTAN,MANAGEMENT,SAFETY,GRAY,PET},
  language     = {eng},
  number       = {15},
  pages        = {1238--1247},
  title        = {Occipital nerve stimulation in medically intractable, chronic cluster headache, the ICON study: rationale and protocol of a randomised trial},
  url          = {http://dx.doi.org/10.1177/0333102413490351},
  volume       = {33},
  year         = {2013},
}

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