Most recently, a randomized sham-controlled VNS migraine study [4] found most of the inter-ictal measured cytokines including IL-6, TNF-α, and HMGB1 unchanged before and after VNS as were the metabolic markers leptin, ghrelin, and adiponectin, although serum concentrations were higher in migraine subjects compared to healthy controls. Here, TNF is linked to migraine disorder.