TY - JOUR
T1 - Trans-nasal high-flow dehumidified air in acute migraine headaches
T2 - A randomized controlled trial
AU - Shah, Rushil
AU - Assis, Fabrizio
AU - Narasimhan, Bharat
AU - Khachadourian, Vahe
AU - Zhou, Shijie
AU - Tandri, Harikrishna
AU - Tariq, Nauman
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The current study was funded by internal grants from the Institute for Clinical and Translational Research (ICTR) at the Johns Hopkins Bayview to the PI (NT).
Publisher Copyright:
© International Headache Society 2021.
PY - 2021/8
Y1 - 2021/8
N2 - Background: Intranasal high flow of dehumidified (dry) air results in evaporative cooling of nasal passages. In this randomized clinical trial, we investigated the effect of dry gas induced nasal cooling on migraine headaches. Methods: In this single-blind study, acute migraineurs were randomized to either nasal high-flow dry oxygen, dry air, humidified oxygen or humidified air (control) at 15 L/min for 15 min. All gases were delivered at 37°C. Severity of headache and other migraine associated symptoms (International Classification for Headache Disorders, 3rd edition criteria) were recorded before and after therapy. The primary endpoint was change in pain scores, while changes in nausea, photosensitivity and sound sensitivity scores served as secondary endpoints. A linear regression model was employed to estimate the impact of individual treatment components and their individual interactions. Results: Fifty-one patients (48 ± 15 years of age, 82% women) were enrolled. When compared to the control arm (humidified air), all therapeutic arms showed a significantly greater reduction in pain scores (primary endpoint) at 2 h of therapy with dry oxygen (−1.6 [95% CI −2.3, −0.9]), dry air (−1.7 [95% CI −2.6, −0.7)]), and humidified oxygen (−2.3 [95% CI −3.5, −1.1]). A significantly greater reduction in 2-h photosensitivity scores was also noted in all therapeutic arms (−1.8 [95% CI −3.2, −0.4], dry oxygen; −1.7 [95% CI −2.9, −0.4], dry air; (−2.1 [95% CI −3.6, −0.6], humidified oxygen) as compared to controls. The presence of oxygen and dryness were independently associated with significant reductions in pain and photosensitivity scores. No adverse events were reported. Conclusion: Trans-nasal high-flow dry gas therapy may have a role in reducing migraine associated pain. Clinical Trial registration: NCT04129567
AB - Background: Intranasal high flow of dehumidified (dry) air results in evaporative cooling of nasal passages. In this randomized clinical trial, we investigated the effect of dry gas induced nasal cooling on migraine headaches. Methods: In this single-blind study, acute migraineurs were randomized to either nasal high-flow dry oxygen, dry air, humidified oxygen or humidified air (control) at 15 L/min for 15 min. All gases were delivered at 37°C. Severity of headache and other migraine associated symptoms (International Classification for Headache Disorders, 3rd edition criteria) were recorded before and after therapy. The primary endpoint was change in pain scores, while changes in nausea, photosensitivity and sound sensitivity scores served as secondary endpoints. A linear regression model was employed to estimate the impact of individual treatment components and their individual interactions. Results: Fifty-one patients (48 ± 15 years of age, 82% women) were enrolled. When compared to the control arm (humidified air), all therapeutic arms showed a significantly greater reduction in pain scores (primary endpoint) at 2 h of therapy with dry oxygen (−1.6 [95% CI −2.3, −0.9]), dry air (−1.7 [95% CI −2.6, −0.7)]), and humidified oxygen (−2.3 [95% CI −3.5, −1.1]). A significantly greater reduction in 2-h photosensitivity scores was also noted in all therapeutic arms (−1.8 [95% CI −3.2, −0.4], dry oxygen; −1.7 [95% CI −2.9, −0.4], dry air; (−2.1 [95% CI −3.6, −0.6], humidified oxygen) as compared to controls. The presence of oxygen and dryness were independently associated with significant reductions in pain and photosensitivity scores. No adverse events were reported. Conclusion: Trans-nasal high-flow dry gas therapy may have a role in reducing migraine associated pain. Clinical Trial registration: NCT04129567
KW - Migraine
KW - dry air
KW - dry oxygen
KW - high-flow gas therapy
KW - humidified air
KW - humidified oxygen
KW - trans-nasal cooling
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U2 - 10.1177/0333102421997766
DO - 10.1177/0333102421997766
M3 - Article
C2 - 33631965
AN - SCOPUS:85101846145
SN - 0333-1024
VL - 41
SP - 968
EP - 978
JO - Cephalalgia
JF - Cephalalgia
IS - 9
ER -