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Migraine relief

Stimulating nerves in the neck with mild electrical pulses appears to offer relief to people with chronic migraine.

Stephen Silberstein, of Thomas Jefferson University in Philadelphia, and his colleagues studied 157 people fitted with a device that periodically stimulates the occipital nerves that feed up the neck into the rear of the brain.

In 105 of the participants, the device was active for three months, while in the others it was switched off. The researchers found that the active device reduced the average number of migraines per month from 22 to 16 – twice the reduction seen when it was switched off (Cephalalgia).

“Presuming the therapy continues to be effective, I would expect the patients it benefits to retain the implant for life,” says Silberstein. The mechanism by which it works remains unknown, he says, but recent research in animals suggests that it reduces concentrations of a pain neurotransmitter in the nerves.

The device was approved a year ago in Europe but is still awaiting approval in the U.S.

No co-pay boosts screenings

Eliminating co-pays may convince more people to seek colorectal cancer screening. Under the Affordable Care Act (ACA) insurers can’t always charge co-pays for certain preventive procedures. In a study in Clinical Gastroenterology, and in 2009, the first year the ACA’s co-pay limit went into effect, the percentage of people who underwent colonoscopy increased by 18 percent.

People often avoid colonoscopy because of the bowel-purging “prep” it requires. However, under the ACA anyone ages 50-75 can get colonoscopy paid for every 10 years. Although a preventive service may be fully covered, the visit to the doctor’s office could still carry a co-pay.

Harvard Health Letter