NEW YORK — A new study spotlighted the trend of using botulinum toxin, including onabotulinum toxinA (OTA), in active military personnel and veterans who have been diagnosed with migraine and post-traumatic headache (PTH). The article in the Journal of Pain Research also sought to describe the efficacy of botulinum toxin administration.1
The Weill Cornell Medicine study, which had participation from the Walter Reed National Military Medical Center in Bethesda, MD, pointed out that servicemembers and veterans represent a unique population in the medical management of headache disorders, particularly migraine.
“They exhibit higher susceptibility to pain of greater intensity and longer durations, possibly due to their history of exposure to combat, trauma, and the associated psychological stresses,” the authors wrote. “Given the burden and morbid nature of these headache disorders, prophylactic measures to reduce migraine attacks and disability are imperative. Specifically, the use of OTA for migraine prophylaxis has been well-validated in chronic migraine.”
The meta-analysis accessed Medline, Embase and Google Scholar for the literature search, and the time frame of the search was set from database inception to April 1, 2024.
The study team identified eight articles meeting the inclusion criteria after screening 43 papers. Studies were primarily conducted in the United States (87.5%), with a single article published on veterans from Taiwan. Study types were mainly retrospective chart reviews, with the exception of two randomized controlled trials. The researchers noted that chronic migraine was the most common headache diagnosis examined, being assessed in six studies, followed by PTH, which was represented in the remaining two studies.
“The occupational exposure of servicemembers appears to result in a higher incidence of headache disorders such as chronic migraine and PTH, which are amenable to preventative management such as that with botulinum toxin,” according to the researchers. “Despite its effectiveness, the use of botulinum toxin in treating headaches and craniofacial pain in servicemembers remains under-researched, warranting further exploration in this population, specifically.”
- Ruan QZ, Pak DJ, Reece DE, Jotwani R, et. Al. The Efficacy of Botulinum Toxin Use in Service Members and Veterans with Migraine and Post-Traumatic Headache Disorders: A Scoping Review. J Pain Res. 2024 Dec 10;17:4177-4186. doi: 10.2147/JPR.S487712. PMID: 39679425; PMCID: PMC11646469.
