Migraine – Where We Are and Where We Are Going
Thank you to Matthew Robbins, MD, FAHS for his contribution to this spotlight!
What is migraine?
Migraine is an inherited, disabling, neurological condition that leads to attacks of head pain, sensitivity to the environment, and other neurological symptoms.
Migraine is a genetic condition, but many factors over a person’s lifetime affect how frequent and severe migraine can be. Migraine attacks may be occasional, but in millions of people attacks are either very frequent or symptoms are constant.
Though migraine attacks may be temporary, migraine is a persistent brain condition that has significant associations with other major medical conditions, including stroke, heart attack, and depression.
Who is affected by migraine?
- Migraine is the third most common and the seventh most disabling medical disorder in the world.
- For a disorder that has plagued humankind since recorded history, we don’t know nearly enough about migraine, or how to prevent or cure it.
- Over 36 million Americans have migraines, more than the number who have diabetes and asthma combined.
- Many of them have chronic migraine, meaning they endure disabling symptoms almost every day robbing them of a full life as family members, employees, and productive members of society.
- One in four homes have a person affected by migraine
- 30% of women and 10% of school-age children experience migraine
- Migraine is an inherited brain condition. If one parent has it, there is a 50% chance of passing it on to a child. If both parents have it, the chances are as high as 75%.
- Migraine frequently occurs after concussion, with over one third of deployed veterans returning with severe headache.
- Migraine is estimated to cost American business more than $29 billion in lost time and lost work productivity.
Current State of Migraine Treatment
- Currently, there is no cure for migraine.
- Only one class of medication (triptans) has ever specifically been fully developed to treat the symptoms of migraine during an attack. Only a small proportion of patients respond to this medication class, and still many others cannot take or tolerate these drugs.
- There are no currently available treatments specifically designed to prevent or reduce the frequency of migraine attacks.
- Getting the right treatment for your type of migraine.
Migraine treatment—what’s out there?
Here are some more resources that may help you better understand treatment for your migraine
- American Headache Society president Lawrence C. Newman, MD, gives a brief overview on the differences between medications that treat symptoms of migraine—such as nausea or pain and medications that target the migraine itself: https://www.youtube.com/watch?v=sY4k21ZFDW0
- How good are relaxation training, biofeedback and behavioral therapy in managing migraine? Read the American Headache Society article on non-pharmacological treatments: Behavioral_and_Other_Nonpharmacologic_Treatments_for_Headache_-_May_2014.pdf
- Here is information on how to find a healthcare professional that provides non-pharmacological treatments for migraine: americanmigrainefoundation.org/find-a-doctortreatment/treatment/behavioral-treatment-of-headache-and-migraine-patients-making-referrals/
Finding a migraine treatment specialist
These articles can help you find the right treatment specialist and what you should expect from a consultation:
- Healthcare Professional Search
- What is a Headache Specialist? Do I Need One? And How Do I Find One?
- Five Things Physicians and Patients Should Question
Why we need more funding for migraine research
After 7,000 years of enduring and searching for relief from migraine, there’s still no cure. Still worse, for the third most common disorder on the planet and the fourth most disabling among women worldwide, we’ve had only one class of medication developed and approved for the treatment of migraine over the last half-century!
Why? Consider this:
- Migraine is trivialized. Although migraine has been a severely disabling disorder for millennia, it is often trivialized by non-migraine sufferers as “just another headache.”
- Migraine is seen as not important. Despite the severe disability and pain associated with migraine, people without migraine view the disorder as episodic and not usually fatal, therefore not a priority for funding.
- Migraine is stigmatized. People with migraine often “play down” its impact on their lives, fearing it will threaten their employability or reliability.
- Migraine is not taught in medical schools. Most physicians received little to no training in migraine which keeps it from being properly recognized as a serious medical condition and/or treated effectively.
Current treatments for migraine are aimed at reducing headache frequency and stopping individual headaches when they occur. Some therapies used to stop the pain can be overused or abused, leading to further deterioration of individuals’ headache condition. Many of these medications are associated with side effects, which limits their use.
Because of these limitations regarding headache treatments, ongoing research is needed to further understand the biology and genetics behind the disease so treatments can be specifically targeted to treat each patient’s headache condition. Additional funding is also needed to explore new therapeutic options that may work in patients who do not respond, or cannot take currently available migraine medications.
As a nation, we allocate a pittance to migraine research—less than 1/20th of 1% of the budget of the National Institutes of Health—or about $20 million a year. That translates to about 55 cents for every person who has migraine. Given the prevalence and magnitude of migraine, $260 million would be right. Industry and the voluntary sector simply cannot make up the difference.
While we know more today than ever before about the brain chemistry and circuits involved, we are still far from safer and more effective treatments. Yet, we have the brain trust—many talented doctors and scientists across the United States and around the world—who know the path forward and know how to get this done. What’s missing is enough money to do the job.