The latest treatment to prevent migraines is a headband that looks more like something you'd expect to see in Star Trek than the doctor's office.
But don't let the slick design fool you. The basic pain-stopping technology inside the Cefaly headband has been around for decades.
The battery-powered headband presses an electrode against a person's forehead, where it sends an electrical signal through the skin to the trigeminal nerve.
By stimulating the nerve, which plays a role in many migraines, the device was shown to help prevent the headaches in a clinical test involving 67 people. Some got the Cefaly device and others used a sham headband. The people who wore the Cefaly device 20 minutes a day took fewer migraine medicines than those who got the dummy device.
This week the Food and Drug Administration cleared the device for marketing in the U.S. The headband, made by STX-Med, costs $295. A package of three electrodes (good for about 60 treatments) runs $25. The company is selling the battery-powered headband online, but you have to email a copy of a doctor's prescription to the company.
A survey of more than 2,300 people who tried the device for two months, on average, found that slightly more than half were satisfied with it and would buy one. But a little less than didn't like it.
Pain specialists and anesthesiologists have used what's called transcutaneous electrical nerve stimulation, or TENS, to relieve pain for decades. Electrodes placed on the skin transmit low-voltage electrical pulses into the tissue and nerves underneath. Cefaly puts the electrode in what looks like a space-age glasses frame.
How does TENS feel? Not too bad, though it can be unsettling to start. "The high frequency and relatively low voltage is pleasant," says Dr. James Rathmell, chief of the pain medicine division at Massachusetts General Hospital in Boston. Conceptually, he says, TENS is about "putting a pleasant sensation over an area where there is a painful sensation." He compares the TENS effect to rubbing a painful patch on your body to make it feel better.
But exactly what TENS does inside the body isn't fully understood. "Empirically, it works, but why it works is less clear," Rathmell tells Shots. It probably changes chemical signaling in nerves, leading to the release of certain neurotransmitters.
As for the Cefaly headband, Rathmell says, "The way they've packaged it makes it quite simple to use. I don't think it's going to be a knock-it-out-of-the-ballpark thing. People may find it somewhat helpful." But there are few risks to TENS either, he says, adding, "I don't think I've ever seen anybody injured by it."
Discomfort with the headband was the most common problem reported in the studies of the device. A company fact sheet says the headband "isn't necessarily painful but the sensation can be uncomfortable at first." A few people had allergic reactions to the electrodes.
Guidelines issued by the American Academy of Neurology in 2012 say that some drugs can help prevent migraines and reduce their severity. Both are worthy medical goals, doctors say. "Migraines beget migraines," Andrew Charles, director of UCLA's Headache Research and Treatment Program, told NPR then. While it's not clear why, the "more migraines a patient gets, the more susceptible they become to having more," he said.
If you want to know what's up with the flu at the moment, you have a few choices: You can get the latest information at Google Flu Trends. Or you can get the official word from the Centers for Disease Control and Prevention, which is based on data that's by now a couple of weeks old.
But a report in the journal Science finds that quicker isn't necessarily better.
This story started in 2008, when scientists at Google realized that they could measure flu activity by tracking when people searched for flu-related terms. They created a handy site called Google Flu Trends. And it works pretty well ... some of the time. But don't bank on it.
"It missed by a huge amount last year and actually, it turns out, it's been missing by a fair amount for several years," says David Lazer, a professor of political science and computer science at Northeastern University. He says Google Flu Trend whiffed during the 2013 flu season.
"It's like bases loaded and bottom of the ninth, striking out on three pitches. They predicted twice as many flu cases as the CDC later said there were."
Lazer has written a critique of Google Flu Trends in the latest issue of Science. He finds that the data collected painstakingly from around the country and forwarded to the CDC is still much better, even with the time lag.
"You could just have used old CDC data, two or three weeks old, and have projected forward, and done a better job than Google Flu Trends," he says.
So does this make Google's approach worthless?
"Not at all," he says. "Not at all. I think, actually, the core idea is a terrific one."
Lazar thinks Google could improve its system with the help of outside scientists if it were less secretive about what exactly it's doing to get its results.
But he sees some inherent problems, as well. Google is always refining its search methods, which is good for people doing Google searches, but not so good for analyzing that data — consistency is important in science.
"If we know ahead of time (that) flu is going to really peak in the next few weeks, we need to start getting additional resources to help manage all these patients who are going to be coming in," says Andrea Dugas, a professor at the Johns Hopkins University School of Medicine and an emergency-room doctor.
During past outbreaks, Hopkins has actually opened up new areas of the hospital to care for flu patients. Dr. Dugas and her colleagues have been working to improve those predictions, looking at various methods to do that.
"The most accurate of those models was the one that looked at the confirmed flu cases," she says. "That one was the most accurate in predicting what was going to happen in the following week."
When they added in the Google Flu Trends data, their prediction improved, she says, but not by a lot.
"Adding that in really helped refine the model and give us a better prediction," she says, "but the main driver for that was the number of flu cases."
She and Dr. Richard Rothman at Hopkins have developed an app — called Flucast — for hospitals to use, to predict the ebb and flow of flu.
Another free app, called Flu Near You, also maps out flu trends, based on reports that individuals submit through the app.
Dr. Dugas says Google's approach is no substitute for lab tests, hospital reports and on-the-ground data. And it's important to note that it's not tracking actual flu caused by influenza viruses - rather it's identifying common symptoms like fever, cough and sore throat.
Google didn't provide a scientist to comment for this story, but a Google report notes one shortcoming: They sometimes get a flood of searches simply when there's a lot of flu in the news. So Google updated the flu tracker system last fall to help reduce the errors that result from that.