The NeurologyLive® team assembled some of the best discussions with leaders in headache and migraine medicine following the 2022 American Headache Society (AHS) Annual Scientific Meeting.
As it does annually, the American Headache Society (AHS) held its scientific meeting in June 2022, bringing together thousands of experts and clinicians who care for patients with migraine and headache, as well as basic science researchers who seek to identify new mechanistic targets and implicated systems.
The sessions and presentations at AHS 2022 included topics such as the therapeutic potential of psychedelics, the need for standardized approaches to status migrainosus, the complexities of neuronal activity during migraine, the role of mindfulness practices for these patients, and the endocannabinoid system's implications in migraine, among others
Swipe through the slideshow below to browse our interviews with experts on-site, and be sure to check back for ongoing coverage from the conference!
On the first day of the meeting, Bryan Roth, MD, PhD, gave a plenary talk that covered the clinical history of psychedelics and the possibility of their use for the treatment of cluster headache. Roth, who is the Michael Hooker Distinguished Professor and director of the NIMH psychoactive drug screening program at the University of North Carolina School of Medicine, sat down with NeurologyLive® while at the meeting to share his insight on the topic.
He currently runs one of the few labs—and perhaps among the only working with federal NIH funding—that evaluates psychedelics and the receptors they act on, work he has conducted since the 1980s. He detailed his background of research into these compounds and the historical evaluations that have been done to this point in this conversation.
Presented by Paige Estave, PhD, an MD-PhD student on the comprehensive headache research team at Wake Forest School of Medicine, the results of a study including semistructured qualitative interviews with adults with migraine was suggestive of mindfulness practices' effect on migraine. In the work, those included had participated in 2 Mindfulness-Based Stress Reduction (MBSR) clinical trials, and their interviews were audio-recorded, transcribed, and then summarized into a framework matrix.1
Estave told NeurologyLive® that the individuals who learned the practice through MBSR reported altered pain perception—measured by quantitative sensory testing—and altered migraine attack response. As well, participants reported an earlier stress-body awareness and an increased interoceptive awareness that allowed for earlier attack recognition, and as a byproduct, earlier and more effective management.
Recently, clinical observations have suggested that clinical endocannabinoid deficiency (CED) might be a possible migraine mechanism for a portion of this patient population, though evidence in the literature has been sparse. Although, some have been conducting basic science investigations into the potential of this as a therapeutic pathway, including Tally Largent-Milnes, PhD, and colleagues.2
Largent-Milnes, an assistant professor of pharmacology at the University of Arizona College of Medicine Tucson, gave a talk on this subject as part of the hot topics in headache session, and while on-site in Denver, she sat down with NeurologyLive® to talk further about her presentation and this research. She offered perspective on the modeling that her group has done in migraine and spoke about the endocannabinoid system’s potential as a therapeutic target for this patient population.
There currently are no evidence-based treatment guidelines for status migrainosus, nor any rational-driven assessments with successful treatment outcomes. Additionally, the existing literature suggest that current treatment approaches to terminating status migrainosus are not satisfactory, pointing to the critical for a refined approach to define treatment response.
On top of this lack of a standardized approach, there is limited epidemiological knowledge available. Rashmi Halker Singh, MD, FAHS, FAAN, associate professor of neurology, Mayo Clinic, and member, board of directors, AHS, spoke with NeurologyLive® about data from her and colleagues' attempt to add to this lack of information, using the Rochester Epidemiology Project to identify incident cases of status migrainosus in Olmsted County, Minnesota between January 1, 2012, and December 31, 2017.3
Amynah Pradhan, PhD, delivered this year’s AHS Harold G. Wolff Award Lecture, focusing on her and colleagues’ work on migraine and peripheral pain models which showed that there are differential alterations in neuronal complexity. Notably, the findings suggest that these distinct cytoarchitectural changes that occur may underlie migraine chronification.4
To find out more about the results and the clinical implications of these critical basic science assessments, NeurologyLive® sat down with Pradhan, who is an associate professor of psychiatry at the University of Illinois at Chicago. She offered some background on her and her colleague’s study and provided clinical context to the results that were presented at this year’s meeting.
Can’t get enough of AHS 2022? The NeurologyLive® team has you covered! With even more coverage beyond these interviews, learn more about the latest research in headache disorders, the progress that the migraine experts are excited about, and other topics of interest. The NeurologyLive® team will continue to add coverage in the coming weeks, so keep checking back!