Patient-Centered Care to Address Symptoms in Migraine Treatment: Amaal Starling, MD, FAHS, FAAN


The associate professor in the department of neurology at Mayo Clinic College of Medicine talked about the importance of adopting a patient-centered approach in migraine treatment and the often overlooked impact of brain fog in patients with migraine. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"In the clinic, when I'm seeing these patients, I should not only ask them about pain-related symptoms but also focus back on what was most important for them, what was most bothersome to them, and [to see if] has that improved."

At the 2023 American Headache Society’s (AHS) Scottsdale Headache Symposium, held November 16-19, in Scottsdale, Arizona, Amaal Starling, MD, FAHS, FAAN, and colleagues presented in a symposium about incorporating recent research into treatment decisions with an anti-calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb). In the symposia, sponsored by Lundbeck, Starling and colleagues underscored the latest data about migraine's impact on focus, symptoms often associated with brain fog, as well as highlighted high-frequency migraine and treatment with eptinezumab (Vyepti; Lundbeck).

Findings from a real-world evidence study showed eptinezumab was associated with a 2-fold increase in average “good days” per month in patients with chronic migraine who used a prior preventive therapy.1 The anti-CGRP mAb was also associated with a significant reduction in acute medication days per month and a decrease in reported brain fog/cognitive impairment. Among 94 participants, the average number of good days per month prior to treatment was 8, which then increased to 18 after beginning the treatment. Following the start of treatment, 86% of participants reported some improvement in brain fog symptoms, 5% reported complete improvement, and 32% reported symptoms were very much improved.

In a recent interview with NeurologyLive®, Starling, an associate professor in the department of neurology at Mayo Clinic College of Medicine, sat down to discuss how clinicians could adopt a more patient-centered approach in migraine treatment to address individual priorities. She also talked about the next steps the scientific community can take to better define and study brain fog as a clinical end point in migraine research. Additionally, Starling spoke about how researchers can ensure that they are asking questions that align with what is most important to the patients, in the context of clinical trials in migraine.

1. Lundbeck to Present New Clinical and Real-World VYEPTI® (eptinezumab-jjmr) Data at the 65th Annual Scientific Meeting of the American Headache Society, Reinforcing Its Use in Migraine Prevention. News Release. Lundbeck. Published June 15, 2023. Accessed January 12, 2023.
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