Evidence map›Paper›PMID 42231198›Full record

Trial reportBMC neurology2026

Migraine phases and treatment response: a post hoc analysis of participants with migraine with aura from the TEAM study.

Michael A L Johnson, Gregory Panza, Deena E Kuruvilla

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03465904 (A Phase III Randomized, Double-blind, Sham-controlled Trial of e-TNS for the Acute Treatment of Migraine), which is not on this map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03465904 nacompletednot on this map

A Phase III Randomized, Double-blind, Sham-controlled Trial of e-TNS for the Acute Treatment of Migraine (The TEAM Study)

TypeinterventionalSponsorCefaly TechnologyRan2018 to 2019Enrolled607ConditionsMigraineArmsVerum Cefaly® Abortive Program device, Sham Cefaly® Abortive Program device
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Michael A L JohnsonTelespecialist LLC, 11215 Metro Pkwy, BLDG 3, Suite 1, Fort Myers, FL, 33966, USA.
Gregory PanzaHartford HealthCare, Hartford, CT, USA.
Deena E KuruvillaBrain Health Institute, Westport, CT, USA. Deenakuruvilla@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMigraine is a phased neurological disorder progressing through prodrome, aura (in approximately one-third of patients), headache, and postdrome. Migraine with aura (MA) and migraine without aura (MO) are pathophysiologically distinct subtypes with potentially different treatment responses. Some acute therapies, including triptans, show reduced efficacy when administered during the aura phase. Whether this extends to neuromodulation remains unclear. This study examined whether the presence of migraine aura-a phase reflecting cortical spreading depolarization-modifies the therapeutic response to acute external trigeminal nerve stimulation (eTNS), using data from the TEAM (Trial of eTNS for the Acute Treatment of Migraine) study.

methodsThis was a post hoc, non-pre-specified analysis from a prospective, multicenter, randomized, double-blind, sham-controlled trial (N = 538). Participants were randomized 1:1 to verum (N = 259) or sham (N = 279) eTNS for 2 h during an active migraine. We compared treatment outcomes between MA (N = 224) and MO (N = 314) participants using logistic regression with interaction terms to test whether aura status modified treatment effect. Models were adjusted for age, sex, and baseline headache severity.

resultsThe MA group had more male participants and higher rates of severe baseline headache pain compared to the MO group. No significant treatment-by-aura interactions were found for any endpoint, including 2-h pain freedom, most bothersome symptom resolution, 2-h pain relief, sustained outcomes at 24 h, or rescue medication use. Adjusted analyses confirmed these findings. The interaction for rescue medication use approached but did not reach significance (P = .054).

conclusionsNo evidence of an interaction was found for the therapeutic effect of eTNS across MA and MO populations, suggesting that the aura phase does not diminish treatment efficacy. eTNS represents a viable non-pharmacological option for acute migraine management regardless of aura status. Future studies should investigate whether timing treatment to specific migraine phases-particularly the prodrome or early aura-can further optimize neuromodulation outcomes.

trial registrationClinicalTrials.gov Identifier: NCT03465904 . Registered 08 March 2018.

Indexed as

Electric Stimulation TherapyMigraine with AuraMigraine without AuraAdultDouble-Blind MethodFemaleHumansMaleMiddle AgedProspective StudiesTreatment Effect HeterogeneityTreatment OutcomeTrigeminal NerveAcute migraine treatmentCortical spreading depolarizationExternal trigeminal nerve stimulationMigraine with auraNeuromodulationTEAM study

Identifiers

PMID42231198
PMCPMC13445680

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.