Author Interviews, Brigham & Women's - Harvard, Neurology, Pain Research / 29.03.2022 Interview with: William R. Renthal, MD, PhD Director of Research, John R. Graham Headache Center Department of Neurology Brigham and Women's Hospital Assistant Professor of Neurology, Harvard Medical School  What is the background for this study?  Response: We know that a nervous system structure called the trigeminal ganglion plays a critical role in migraine headache, but the cell types that exist in this structure are poorly understood. We have used cutting-edge, single-cell genomic technologies to profile the genes expressed within each trigeminal ganglion cell type in both human and mouse with the goal of identifying molecular features that could allow us to inhibit head pain selectively without affecting other cell types. (more…)
Author Interviews, NEJM, Neurology, Pain Research / 18.08.2021 Interview with: Jessica Ailani M.D. FAHS FAAN FANA Director Medstar Georgetown Headache Center Vice Co-Chair of Strategic Planning for MedStar Neurology Professor of Clinical Neurology MedStar Georgetown University Hospital What is the background for this study? Response: Migraine is a common neurological disease that causes disabling attacks that can be frequent. Preventive treatments can help reduce the frequency of attacks and improve patient function, reducing disease burden. (more…)
Author Interviews, JAMA, Pain Research / 11.06.2020 Interview with: Tobias Kurth, MD, ScD (Pronouns: he/him) Professor of Public Health and Epidemiology Director, Institute of Public Health Charité – Universitätsmedizin Berlin What is the background for this study? Response: Migraine (with aura) has been associated with increased risk of cardiovascular disease but its absolute contribution in relation to other major vascular risk factors was not unclear. (more…)
Author Interviews, Neurological Disorders, Neurology, Pain Research / 11.05.2020 Interview with: Holly Yancy, DO Headache medicine specialist Banner – University Medicine Neuroscience Institute Phoenix, AZ Dr. Yancy comments on the recent Neurology journal article on the potential impact of yoga on migraine. What is the background for this study? How might yoga reduce migraine intensity or frequency?  Response: The authors of this trial have studied the benefits of yoga when added to medical management of episodic migraine. They expand on prior, smaller reports of the potential benefit of yoga and mindfulness to migraine patients with a well-designed study that shows yoga, as an adjunct to preventive medication, can lower the intensity, frequency and impact of migraines. Participants even used less abortive medication. The authors propose multiple potential mechanisms of action, including an increase in parasympathetic / decrease in sympathetic nervous system activity, decreased muscle tension, and stress management. (more…)
Author Interviews, JAMA, Neurology, Ophthalmology, Pain Research / 27.11.2019 Interview with: Priv.-Doz. Dr. med. Christoph Schankin Consultant Head University Headache Clinic Department of Neurology Inselspital, Bern University Hospital University of Bern What is the background for this study? Response: Visual snow syndrome is a debilitating disorder with a continuous TV snow-like visual disturbance that persists over years. Patients have additional visual problems, such as severe afterimages, floaters or photophobia. The syndrome is associated with migraine and migraine aura, but the interaction between the two remains unclear. (more…)
Author Interviews, Brigham & Women's - Harvard, Emergency Care, Pain Research / 07.05.2018 Interview with: Paul B. Rizzoli, M.D., FAAN, FAHS Department of Neurology Brigham and Women’s Hospital Clinical and Fellowship Director, John R Graham Headache Center Brigham and Women’s Faulkner Hospital Assistant Professor of Neurology Harvard Medical School What is the background for this study? What are the main findings?  Response: Migraine and other recurrent headache disorders disproportionately affect otherwise healthy, middle-aged people, particularly women, and are a leading cause of suffering and disability. Accurate epidemiologic information is vital for providers, researchers and policy makers. In this paper we surveyed the most recent data from population-based studies in the United States to assess the burden and impact of these conditions. Our search included such sources as the National Health Interview Study (NHIS), the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Ambulatory Medical Care Survey (NAMCS). We found that the prevalence and burden of self-reported migraine and other severe headache has remained stable but high in the past 19 years, affecting roughly 1 out of every 6 Americans (15.3%) and 1 in 5 women (20.7%) over a 3-month period. Among other findings was that headache is proportionately more burdensome those in middle age (elderly also), those who are unemployed and those who are disabled or who have low family income. Headache represents roughly 3% of all annual emergency department visits.  (more…)
Author Interviews, BMJ, Heart Disease, Pain Research, Stroke / 04.04.2018 Interview with: Islam Elgendy MD Division of Cardiovascular Medicine University of Florida What is the background for this study? What are the main findings?  Response: Migraine headache is a prevalent medical condition, often being chronic and debilitating to many. Previous studies have shown that migraine, particularly migraine with aura, is associated with an increased risk of cardiovascular events. Recently, a number of these studies have reported long-term follow up data. To better understand the long-term morbidity that is associated with migraines, we performed a systematic evaluation to study the link between migraine and risk of cardiovascular and cerebrovascular events. This study demonstrated that migraine is associated with an increased risk of major adverse cardiovascular and cerebrovascular events, which was driven by an increased long-term risk of myocardial infarction and stroke. This effect was predominantly observed in migraineurs who have aura.  (more…)
Author Interviews, Pain Research, Surgical Research / 05.01.2018 Interview with: “Migraine” by makelessnoise is licensed under CC BY 2.0Lisa Gfrerer, MD PhD Clinical Fellow in Surgery Brigham and Women's Hospital William Gerald Austen MD Chief, Plastic and Reconstructive Surgery Chief, Division of Burn Surgery Massachusetts General Hospital What are the main findings? Response: Migraine surgery patients at our institution are chronic pain patients who have failed conservative therapy and are severely disabled by their disease. We initiated this study to understand two important points. First, it was previously unclear how to categorize these patients in terms of pain intensity and disability on the spectrum of better known pain conditions such as chronic back pain/ nerve pain/ carpal tunnel.  This is very important to appreciate the extent of this disease. Second, instead of collecting migraine characteristic such as decrease in migraine days/ duration/ pain, we wanted to understand how functionally disabled these patients are in their daily lives and how much better they get after surgery. This is ultimately what matters to patients. We therefore decided to evaluate our outcomes by using the Pain Self Efficacy Questionnaires (PSEQ). This validated pain questionnaire has been used to describe pain intensity/disability in patients with different acute and chronic pain conditions. (more…)
Author Interviews, CT Scanning, Emergency Care, Pain Research / 14.11.2017 Interview with: Jeff Perry, MD, MSc, CCFP-EM Professor, Department of Emergency Medicine Senior Scientist, Ottawa Hospital Research Institute Research Chair in Emergency Neurological Research, University of Ottawa Emergency Physician and Epidemiology Program The Ottawa Hospital Ottawa, Ontario What is the background for this study? What are the main findings? Response: Headache accounts for about 1-2% of all emergency department visits.  One of the most feared diagnosis within these patients is subarachnoid hemorrhage. While investigations are clearly warranted for patients with a diminished level of consciousness or new focal neurological deficits, approximately 50% of patients with subarachnoid hemorrhage (SAH) have no focal or global neurological findings. Deciding whether to image headache patients with no deficits is difficult, especially since timely diagnosis and treatment results in substantially better outcomes. The desire to never miss a subarachnoid hemorrhage, however, contributes to escalating neuroimaging rates and a dogmatic adherence to lumbar puncture, even if the scan is negative, despite the very high sensitivity of computed tomography. However, a recent population-based study suggested that over 5% of confirmed subarachnoid hemorrhages were missed at initial presentation, especially in smaller hospitals. Therefore, identifying which headache patients require investigations to rule-out SAH is of great importance. We have previously derived (N=1,999) and refined (N=2,131) the Ottawa SAH Rule. In this study, we conducted an multicenter prospective cohort study at six tertiary care hospitals, and found that the Ottawa SAH Rule performed well, with an 100% sensitivity, and specificity of 13.6%. (more…)
Author Interviews, Mental Health Research, Pain Research / 20.10.2017 Interview with: Fu-Chi Yang, M.D., Ph.D.Assistant Professor Department of Neurology, Tri-Service General Hospital National Defense Medical Center Taipei, Taiwan What is the background for this study? What are the main findings? Response: Migraineurs are likely to suffer from comorbid depression and anxiety. Furthermore, increased migraine frequency is associated with an increased risk of mood/anxiety disorders. It is not distinguished by grouping frequency of migraine attacks, whether it is associated with severity scores of depression and anxiety. Thus, we evaluated the relationship between severity of depression/anxiety and migraine frequency We mainly found that the severity of depression (BDI and HADS-depression scores) and anxiety (HADS anxiety score) were related to migraine frequency, after adjusting confounding factors. (more…)
Author Interviews, JAMA, Pain Research, Stroke / 08.03.2017 Interview with: Alessandro Pezzini, MD, FESO Professore Associato di Neurologia Dipartimento di Scienze Cliniche e Sperimentali Clinica Neurologica Università degli Studi di Brescia Italia What is the background for this study? What are the main findings? Response: Scarce reports have suggested that a relation might exist between migraine and cervical artery dissection (CEAD), the most frequent cause of ischemic stroke in young adults in Western countries. However, data available so far were obtained from few studies conducted on small cohorts of patients, which limits the generalizability of their findings. In our study we analysed the data from the Italian Project on Stroke in Young Adults (IPSYS) project, one of the largest registries of young ischemic stroke patients, and observed that migraine, especially the subtype without aura was strongly and independently associated to CEAD. This seems particularly true for men and for people younger than 39 years. (more…)
Author Interviews, Nature, Pain Research, Vitamin D / 09.01.2017 Interview with: What is the background for this study? What are the main findings? Response: Formation of vitamin D in the skin with UVB light from the sun is a main source of vitamin D during summer months, but in the winter months the UVB light is too weak for vitamin D production. Headache prevalence has been suggested to be related to increasing latitude (less UVB light throughout the year) and possibly to be less prevalent during summer (more UVB light), which suggests a possible role for vitamin D exposure. Some previous small studies have suggested that low serum vitamin D levels might be associated with more frequent headache or migraine. Our study included 2601 men from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) from eastern Finland, aged 42-60 years in 1984-1989, which makes it one of the largest studies so far regarding vitamin D and headache. In our study chronic headache (occurring weakly or daily) was reported by 250 men, and men reporting chronic headache had lower serum vitamin D levels than others. When we divided the study population into four groups based on their serum vitamin D levels, the group with the lowest levels had over a twofold risk of chronic headache in comparison to the group with the highest levels. Chronic headache was also more frequently reported by men who were examined outside the summer months of June through September. (more…)
Author Interviews, Emergency Care, Neurological Disorders, NYU, Pain Research / 30.06.2016 Interview with: Mia Minen, MD, MPH Assistant Professor of Neurology NYU Langone Medical Center Editor’s note: The American Headache Society has issued new guidelines on “The Management of Adults With Acute Migraine in the Emergency Department” (1,2) Dr. Minen, Director of Headache Services at NYU Langone Medical Center, discusses these new guidelines below. What is the background for these new guidelines? How common/severe is the issue of migraine or headache presentation to the ER? Dr. Minen: These guidelines were needed because previous research shows that there are about 1.2. million visits to the emergency department (ED) each year for migraine, and over 25 different medications are sometimes used for treatment. Many of these medications don’t have evidence-based data to back their usage, and opioids are especially likely to be prescribed in between 60 and 70 percent of these cases, despite their lack of efficacy and risks. The American Headache Society convened an expert panel to review the existing evidence on all the medications used to treat migraines in the ED, and we developed these new treatment guidelines. (more…)
Author Interviews, Neurological Disorders, NYU, Opiods, Pain Research, Pharmacology / 25.06.2015

Dr. Mia T. Minen, MD, MPH Director, Headache Services at NYU Langone Medical Center Assistant professor, Department of Neurology Interview with: Dr. Mia T. Minen, MD, MPH Director, Headache Services NYU Langone Medical Center Assistant professor, Department of Neurology   Medical Research: What is the background for this study? What are the main findings? Dr. Minen: We conducted a survey on opioid and barbiturate use among patients visiting a headache center to find out which medications they were receiving for treatment. There’s limited evidence that long-term use of these medications can help treat headaches or migraines, and even short-term use in small quantities can cause medication overuse headache. It is important to determine which providers start these medications so that educational interventions can be tailored to these physician specialties to try to prevent situations such as incorrect prescribing practices and medication overuse. In this sample of patients from a specialty headache center, approximately 20 percent of patients -- or 1 in 5 -- were using opioids or barbiturates, and about half had been prescribed these medications at some point in the past for their headaches. These findings show that opioids and barbiturates are commonly prescribed to patients with headaches. While two-thirds of patients found opioids or barbiturates helpful, many did not like them, were limited by side effects or did not find them to be helpful. Emergency department physicians were reported to be the most frequent first prescribers of opioids and general neurologists were the most frequent prescribers of barbiturate-containing medications. Primary care physicians were also identified as frequent first prescribers of these medications. (more…)
Author Interviews, Cost of Health Care, JAMA, Pain Research, Pharmacology, Radiology, University of Michigan / 17.03.2014

Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann Interview Invitation with: Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann Arbor What are the main findings of the study? Dr. Callaghan:  The main findings are that we order headache neuroimaging (MRIs and CTs) frequently, this accounts for approximately $1 billion dollars annually, and the number of tests ordered is only increasing with time. (more…)