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Repetitive GON Blockade for Menstrual Migraine

3. maj 2026 opdateret af: NAZLI GAMZE BÜLBÜL, Saglik Bilimleri Universitesi

Perimenstrual Repetitive Greater Occipital Nerve Blockade for Menstrual Migraine: A Randomized, Double-Blind, Placebo-Controlled Trial

: The primary objective of this prospective, randomized, double-blind, placebo-controlled clinical trial is to evaluate whether repetitive bilateral greater occipital nerve (GON) blockade administered with a local anesthetic (0.5% bupivacaine) significantly reduces headache severity, attack duration, and the number of pain days in female patients with menstrual migraine compared to a placebo group (normal saline). Patients will receive injections twice a month for three months (seven days before the expected onset of menstruation and on the first day of menstruation).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Menstrual migraine (MM) is a highly prevalent and challenging migraine subtype triggered by fluctuations in estrogen and progesterone levels, particularly estrogen withdrawal during the perimenstrual period

  • This hormonal withdrawal sensitizes the trigeminovascular system and promotes the release of neuropeptides such as calcitonin gene-related peptide (CGRP)
  • Currently, there are no licensed prophylactic medications specifically developed for MM, making alternative and non-systemic treatments necessary

This study investigates the efficacy of a targeted peripheral neuromodulation approach using bilateral greater occipital nerve (GON) blockade. The underlying clinical rationale is that GON blockade timed to the perimenstrual period can modulate nociceptive transmission at the trigeminocervical complex (TCC) and decrease peripheral nerve excitability, thereby limiting the impact of cyclic hormonal fluctuations on the trigeminovascular system

. In this trial, a Latin square experimental design is utilized to ensure balanced randomization between the active treatment and placebo groups

  • Unlike single-injection protocols, the intervention is specifically synchronized with the patients' menstrual cycles, involving injections twice a month over a three-month period (seven days before menstruation and on the first day of menstruation)
  • By evaluating this specific timing and repetitive protocol, the study aims to establish whether perimenstrual-targeted GON blockade can serve as an effective, non-systemic, short-term prophylactic strategy for patients suffering from this refractory migraine subtype.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

48

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Tyrkiet (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Tyrkiet (Türkiye), 34668
        • Saglik Bilimleri Universitesi

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Diagnosed with pure menstrual migraine or menstrually related migraine according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) diagnostic criteria.
  • A documented history of migraine attacks during the perimenstrual period (between days -2 and +3 relative to the onset of menstruation) in at least two of the last three menstrual cycles.

Exclusion Criteria:

  • Diagnosis of chronic migraine.
  • Presence of an additional primary or secondary headache disorder.
  • Pregnant or lactating.
  • Known hypersensitivity to local anesthetics.
  • Received an occipital nerve blockade within the last three months.
  • Presence of a significant neurological or systemic disease that could affect the outcome evaluation.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Active Treatment: 0.5% Bupivacaine
Patients receive bilateral greater occipital nerve (GON) blockade using 0.5% bupivacaine. Injections are administered twice a month for three months (seven days before the expected onset of menstruation and on the first day of menstruation).
Medicin: 0.5% bupivacaine
Bilateral greater occipital nerve (GON) blockade using a local anesthetic.
Placebo komparator: Placebo: Normal Saline
Patients receive bilateral greater occipital nerve (GON) blockade using an equivalent volume of normal saline. Injections are administered twice a month for three months, following the same schedule as the active treatment group.
Andet: Normal Saline
Bilateral greater occipital nerve (GON) blockade using placebo (normal saline).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in headache severity evaluated using the Visual Analog Scale (VAS)
Tidsramme: Baseline, Month 3, and Month 6
Headache severity measured by VAS.
Baseline, Month 3, and Month 6

Sekundære resultatmål

Resultatmål
Tidsramme
Change in monthly migraine attack frequency
Tidsramme: Baseline, Month 3, and Month 6
Baseline, Month 3, and Month 6
Change in number of headache days per month
Tidsramme: Baseline, Month 3, and Month 6
Baseline, Month 3, and Month 6
Change in mean attack duration in hours
Tidsramme: Baseline, Month 3, and Month 6
Baseline, Month 3, and Month 6
Change in monthly analgesic consumption
Tidsramme: Baseline, Month 3, and Month 6
Baseline, Month 3, and Month 6
Change in Migraine Disability Assessment (MIDAS) scores
Tidsramme: Baseline, Month 3, and Month 6
Baseline, Month 3, and Month 6

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Saglik Bilimleri Universitesi

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

19. oktober 2024

Primær færdiggørelse (Faktiske)

30. maj 2025

Studieafslutning (Faktiske)

30. november 2025

Datoer for studieregistrering

Først indsendt

3. maj 2026

Først indsendt, der opfyldte QC-kriterier

3. maj 2026

Først opslået (Faktiske)

8. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • E66291034-202.3.02-5953

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

The data supporting the findings of this study is available from the corresponding author upon reasonable request.

IPD-delingstidsramme

Data will become available immediately following the publication of the study results and will remain accessible indefinitely.

IPD-delingsadgangskriterier

De-identified individual participant data that underlie the results reported in this article will be shared. Data will be available to researchers who provide a methodologically sound proposal to achieve aims in the approved proposal. Requests should be directed to the corresponding author via email. Access may require signing a data access agreement.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP

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Kliniske forsøg med 0.5% bupivacaine

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