Oxygen Therapy in Cluster Headache, Migraine, and Other Headache Disorders

Heejung Mo, Soo Jie Chung, Todd D Rozen, Soo-Jin Cho, Heejung Mo, Soo Jie Chung, Todd D Rozen, Soo-Jin Cho

Abstract

Oxygen therapy (OT) can relieve head pain in certain primary headache disorders, including cluster headache (CH). The exact underlying mechanism is currently uncertain, but suggested mechanisms include inhibition of the trigeminoautonomic reflex, modulation of neurotransmitters, and cerebral vasoconstriction. OT is the standard for acute treatment of CH, but patients with CH often experience considerable difficulties accessing home OT due to problems with insurance coverage. Inhalation of 100% oxygen at 6-12 L/min for 15-30 min using a non-rebreather face mask is one of the most effective acute therapies for CH, but several trials have indicated the superiority of higher oxygen flow rates of up to 15 L/min and/or using a demand-valve oxygen mask that can produce very high flow rates. Two randomized controlled trials have demonstrated the efficacy of OT in migraine, but obtaining reliable evidence is considered difficult because of different inhalation protocols, varying outcome measures, and small samples. There are some reports on the efficacy of OT as an adjuvant therapy in hypnic headache, primary headache in the emergency department, and even postdural puncture headache. The goal of this review article is to expand the knowledge regarding the use of oxygen in the treatment of headache disorders.

Keywords: cluster headache; demand-valve oxygen; masks; migraine disorders; oxygen inhalation therapy; trigeminal autonomic cephalalgias.

Conflict of interest statement

Dr. Mo was involved as a site investigator of multicenter trial sponsored Biohaven Asia Pacific Ltd. Dr. Cho was involved as a site investigator of multicenter trial sponsored Otsuka Korea, Allergan, Ildong Pharmaceutical Co., LTD, Novartis International AG, Eli Lilly and Company, Hyundaipharm. Co. Ltd., Biohaven Asia Pacific Ltd, H. Lundbeck A/S (Lundbeck), and Parexel Korea Co., Ltd., and received lecture honoraria from Allergan Korea, WhanIn Pharm Co., LTD, Shinpoong Pharma. Co., Ltd, and SK chemicals in the past 24 months. Dr. Chung reported no conflict of interest. Dr. Rozen nothing to disclose, no conflict of interest.

Copyright © 2022 Korean Neurological Association.

Figures

Fig. 1. Flow chart of the study…
Fig. 1. Flow chart of the study selection.
Fig. 2. Process of inhalation of oxygen…
Fig. 2. Process of inhalation of oxygen via different routes to the lung and brain, multiple factors affecting the fraction of inspired oxygen, and efficacy of oxygen therapy.

References

    1. Allardet-Servent J, Sicard G, Metz V, Chiche L. Benefits and risks of oxygen therapy during acute medical illness: just a matter of dose! Rev Med Interne. 2019;40:670–676.
    1. Speizer FE, Horton S, Batt J, Slutsky AS. In: Disease Control Priorities in Developing Countries. Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, editors. Washington DC: The International Bank for Reconstruction and Development; 2006. Respiratory diseases of adults; pp. 681–693.
    1. Petty TL. Home oxygen therapy. Mayo Clin Proc. 1987;62:841–847.
    1. Kudrow L. Response of cluster headache attacks to oxygen inhalation. Headache. 1981;21:1–4.
    1. Cohen AS, Burns B, Goadsby PJ. High-flow oxygen for treatment of cluster headache: a randomized trial. JAMA. 2009;302:2451–2457.
    1. Fogan L. Treatment of cluster headache. A double-blind comparison of oxygen v air inhalation. Arch Neurol. 1985;42:362–363.
    1. May A, Leone M, Afra J, Linde M, Sándor PS, Evers S, et al. EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias. Eur J Neurol. 2006;13:1066–1077.
    1. Robbins MS, Starling AJ, Pringsheim TM, Becker WJ, Schwedt TJ. Treatment of cluster headache: the American Headache Society evidence-based guidelines. Headache. 2016;56:1093–1106.
    1. Tepper SJ, Duplin J, Nye B, Tepper DE. Prescribing oxygen for cluster headache: a guide for the provider. Headache. 2017;57:1428–1430.
    1. Chung PW, Cho SJ, Kim BK, Kim SK, Lee MJ, Choi YJ, et al. Development and validation of the cluster headache screening questionnaire. J Clin Neurol. 2019;15:90–96.
    1. Jürgens TP, Schulte LH, May A. Oxygen treatment is effective in migraine with autonomic symptoms. Cephalalgia. 2013;33:65–67.
    1. Alvarez WC, Mason AY. Results obtained in the treatment of headache with the inhalation of pure oxygen. Anesthesiology. 1941;2:108
    1. Horton BT. Histaminic cephalgia. J Lancet. 1952;72:92–98.
    1. Guo XN, Lu JJ, Ni JQ, Lu HF, Zhao HR, Chen G. The role of oxygen in cluster headache. Med Gas Res. 2019;9:229–231.
    1. Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Ann Intern Med. 1980;93:391–398.
    1. Singhal AB, Maas MB, Goldstein JN, Mills BB, Chen DW, Ayata C, et al. High-flow oxygen therapy for treatment of acute migraine: a randomized crossover trial. Cephalalgia. 2017;37:730–736.
    1. Shah R, Assis F, Narasimhan B, Khachadourian V, Zhou S, Tandri H, et al. Trans-nasal high-flow dehumidified air in acute migraine headaches: a randomized controlled trial. Cephalalgia. 2021;41:968–978.
    1. Oude Nijhuis JC, Haane DY, Koehler PJ. A review of the current and potential oxygen delivery systems and techniques utilized in cluster headache attacks. Cephalalgia. 2016;36:970–979.
    1. Nasilowski J, Przybylowski T, Zielinski J, Chazan R. Comparing supplementary oxygen benefits from a portable oxygen concentrator and a liquid oxygen portable device during a walk test in COPD patients on long-term oxygen therapy. Respir Med. 2008;102:1021–1025.
    1. Bennett MH, French C, Schnabel A, Wasiak J, Kranke P, Weibel S. Normobaric and hyperbaric oxygen therapy for the treatment and prevention of migraine and cluster headache. Cochrane Database Syst Rev. 2015;2015:CD005219
    1. Rozen TD, Fishman RS. Demand valve oxygen: a promising new oxygen delivery system for the acute treatment of cluster headache. Pain Med. 2013;14:455–459.
    1. Akerman S, Holland PR, Lasalandra MP, Goadsby PJ. Oxygen inhibits neuronal activation in the trigeminocervical complex after stimulation of trigeminal autonomic reflex, but not during direct dural activation of trigeminal afferents. Headache. 2009;49:1131–1143.
    1. Gooriah R, Buture A, Ahmed F. Evidence-based treatments for cluster headache. Ther Clin Risk Manag. 2015;11:1687–1696.
    1. Rozen TD. Inhaled oxygen for cluster headache: efficacy, mechanism of action, utilization, and economics. Curr Pain Headache Rep. 2012;16:175–179.
    1. McLeod MS, Andrasik F, Packard RC, Miller BD. Cold room air inhalation to abort cluster headaches: an exploratory study. J Headache Pain. 2002;3:33–36.
    1. Chuquet J, Hollender L, Nimchinsky EA. High-resolution in vivo imaging of the neurovascular unit during spreading depression. J Neurosci. 2007;27:4036–4044.
    1. Takano T, Tian GF, Peng W, Lou N, Lovatt D, Hansen AJ, et al. Cortical spreading depression causes and coincides with tissue hypoxia. Nat Neurosci. 2007;10:754–762.
    1. Hong YH, Cho SJ, Bae DW, Chung PW, Moon HS, Chu MK, et al. Exploratory study of the effectiveness of oxygen therapy using home oxygen concentrators for cluster headache. J Korean Neurol Assoc. 2020;38:29–32.
    1. Petersen AS, Barloese MC, Lund NL, Jensen RH. Oxygen therapy for cluster headache. A mask comparison trial. A single-blinded, placebo-controlled, crossover study. Cephalalgia. 2017;37:214–224.
    1. Dirkx THT, Haane DYP, Koehler PJ. Oxygen treatment for cluster headache attacks at different flow rates: a double-blind, randomized, crossover study. J Headache Pain. 2018;19:94.
    1. Pearson SM, Burish MJ, Shapiro RE, Yan Y, Schor LI. Effectiveness of oxygen and other acute treatments for cluster headache: results from the cluster headache questionnaire, an international survey. Headache. 2019;59:235–249.
    1. Petersen AS, Lund N, Jensen RH, Barloese M. Real-life treatment of cluster headache in a tertiary headache center - results from the Danish Cluster Headache Survey. Cephalalgia. 2021;41:525–534.
    1. Schindler EAD, Wright DA, Weil MJ, Gottschalk CH, Pittman BP, Sico JJ. Survey analysis of the use, effectiveness, and patient-reported tolerability of inhaled oxygen compared with injectable sumatriptan for the acute treatment of cluster headache. Headache. 2018;58:1568–1578.
    1. Schürks M, Rosskopf D, de Jesus J, Jonjic M, Diener HC, Kurth T. Predictors of acute treatment response among patients with cluster headache. Headache. 2007;47:1079–1084.
    1. Leroux E, Ducros A. Cluster headache. Orphanet J Rare Dis. 2008;3:20.
    1. Haane DY, de Ceuster LM, Geerlings RP, Dirkx TH, Koehler PJ. Cluster headache and oxygen: is it possible to predict which patients will be relieved? A prospective cross-sectional correlation study. J Neurol. 2013;260:2596–2605.
    1. O’Brien M, Ford JH, Aurora SK, Govindan S, Tepper DE, Tepper SJ. Economics of inhaled oxygen use as an acute therapy for cluster headache in the United States of America. Headache. 2017;57:1416–1427.
    1. Sohn JH, Choi YJ, Kim BK, Chung PW, Lee MJ, Chu MK, et al. Clinical features of probable cluster headache: a prospective, cross-sectional multicenter study. Front Neurol. 2018;9:908.
    1. Magis D. Emerging treatments for cluster headache: hopes and disappointments. Curr Opin Neurol. 2019;32:432–437.
    1. Evers S, Rapoport A International Headache Society. The use of oxygen in cluster headache treatment worldwide - a survey of the International Headache Society (IHS) Cephalalgia. 2017;37:396–398.
    1. Ministry of Health, Labor and Welfare Japan. Basic policy for revision of medical fees in 2018 [Internet] Tokyo: Ministry of Health, Labor and Welfare; [cited 2021 Dec 12]. Available from: .
    1. Center for Medicare and Medicaid Services. Home use of oxygen to treat cluster headache [Internet] Baltimore, MD: Center for Medicare and Medicaid Services; [cited 2021 Dec 12]. Available from: .
    1. Kwon DI. Cluster headache, like stabbing the eye with a knife, takes 5 years to diagnose [Internet] Seoul: The Korea Times; 2020. Sep 15, [cited 2021 Dec 12]. Available from: .
    1. Choi YJ, Kim BK, Chung PW, Lee MJ, Park JW, Chu MK, et al. Impact of cluster headache on employment status and job burden: a prospective cross-sectional multicenter study. J Headache Pain. 2018;19:78.
    1. Rozen TD. Cluster headache clinical phenotypes: tobacco nonexposed (never smoker and no parental secondary smoke exposure as a child) versus tobacco-exposed: results from the United States Cluster Headache Survey. Headache. 2018;58:688–699.
    1. Burish M. Cluster headache and other trigeminal autonomic cephalalgias. Continuum (Minneap Minn) 2018;24(4, Headache):1137–1156.
    1. Cohen AS. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. Cephalalgia. 2007;27:824–832.
    1. Evers S, Husstedt IW. Alternatives in drug treatment of chronic paroxysmal hemicrania. Headache. 1996;36:429–432.
    1. Holle D, Naegel S, Krebs S, Katsarava Z, Diener HC, Gaul C, et al. Clinical characteristics and therapeutic options in hypnic headache. Cephalalgia. 2010;30:1435–1442.
    1. Horton BT, Peters GA. Clinical manifestations of excessive use of ergotamine preparations and mangement of withdrawal effect: report of 52 cases. Headache. 1963;2:214–227.
    1. Roldan CJ, Chung M, Mc C, Cata J, Huh B. High-flow oxygen and proserotonin agents for non-interventional treatment of post-dural-puncture headache. Am J Emerg Med. 2020;38:2625–2628.
    1. Rozen TD, Fishman RS. Female cluster headache in the United States of America: what are the gender differences? Results from the United States Cluster Headache Survey. J Neurol Sci. 2012;317:17–28.
    1. Rockswold SB, Rockswold GL, Zaun DA, Zhang X, Cerra CE, Bergman TA, et al. A prospective, randomized clinical trial to compare the effect of hyperbaric to normobaric hyperoxia on cerebral metabolism, intracranial pressure, and oxygen toxicity in severe traumatic brain injury. J Neurosurg. 2010;112:1080–1094.
    1. Barazzone C, Horowitz S, Donati YR, Rodriguez I, Piguet PF. Oxygen toxicity in mouse lung: pathways to cell death. Am J Respir Cell Mol Biol. 1998;19:573–581.
    1. Chung PW, Kim BS, Park JW, Sohn JH, Lee MJ, Kim BK, et al. Smoking history and clinical features of cluster headache: results from the Korean cluster headache registry. J Clin Neurol. 2021;17:229–235.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다