Percutaneous 60-Day Peripheral Nerve Stimulation Provides Effective Pain Relief from Occipital Head Pain in the Presence of Migraine: Results from a Prospective, Single-Arm, Multicenter Pilot Study

Friday, October 24, 2025

8:00 AM - 9:15 AM MT

Location: Kiosk 10

Poster Presenter(s)

Matthew Pingree, MD

Assistant Professor, Division of Pain Medicine, Dept. of Anesthesiology and Perioperative Meeting
Mayo Clinic
Rochester, Minnesota

Co-Author(s)

NK

Narayan Kissoon, MD

Assistant Professor
Mayo Clinic
, Rochester, Minnesota
GG

Genaro Gutierrez, MD

Physician, Medical Director
Pain Specialists of America
Austin, Texas
Zachary McCormick, MD

Professor and Vice Chair of PM&R; Chief of Spine and Musculoskeletal Medicine
University of Utah
Salt Lake City, Utah
Christopher A. Gilmore, MD

President
Carolinas Pain Institute
Winston Salem, North Carolina
ME

Mitchell Engle, MD, PhD

Physician
Institute of Precision Pain Medicine
Corpus Christi, Texas

Primary Author(s)

William Huffman, PhD

Research Engineer
SPR
Cleveland, Ohio

Co-Author(s)

NC

Nate D. Crosby, PhD

Senior Manager, R&D
SPR
Cleveland, Ohio
JB

Joseph Boggs, PhD

Chief Scientific Officer, Senior Vice President of R&D
SPR
Chapel Hill, North Carolina

Disclosure(s):

Matthew Pingree, MD: No relevant disclosure to display

Narayan Kissoon, MD: No relevant disclosure to display

Zachary McCormick, MD: No relevant disclosure to display

Christopher A. Gilmore, MD: No relevant disclosure to display

Nate D. Crosby, PhD: No relevant disclosure to display

Background and/or Objectives: Disabling occipital head pain due to cervicogenic headache (CGH) or occipital neuralgia (ON) can interfere with daily activities and decrease quality of life. These negative effects can be more pronounced when a patient presents with migraine-like features (e.g., photophobia, nausea). There is a substantial need for effective treatment options for patients with concurrent occipital head pain and characteristics of migraine. The goal of the present study was to collect data on the efficacy and safety of the 60-day PNS treatment among patients with ON or CGH along with concurrent migraine.

Design: This IRB-approved, prospective, single-arm pilot study enrolled participants with occipital head pain and migraines.

Setting : Multi-center study conducted at academic medical centers and private practice clinics.

Participants : Eleven participants were enrolled in the study. Patients were required to have occipital head pain due to CGH or ON with a prior migraine diagnosis and an ID Migraine screener score ≥2.

Interventions: Participants received percutaneous, helically-coiled leads targeting the greater and third occipital nerves (GON and TON, respectively) near the C2 lamina with stimulation for up to 60 days.

Main Outcome Measures: Response to treatment was defined as the proportion of participants with ≥50% reduction in average pain intensity and/or pain interference.

Results: At EOT, a majority of participants (82%, n=9/11) reported substantial (≥50%) relief from pain and/or pain interference compared to baseline, with responders experiencing an average reduction of pain intensity and pain interference of 72% and 65%, respectively. The most common adverse events (AE) were skin irritation or itching. Two infections were reported in two participants at the lead exit sites (one classified as serious) and both resolved after a course of antibiotics.

Conclusions: Percutaneous 60-day PNS treatment may effectively reduce pain and pain interference among patients with occipital head pain with migraine-like features.