The Persistent Burden of Migraine Despite Treatment Advances: Amaal Starling, MD, FAHS, FAAN


The associate professor in the department of neurology at Mayo Clinic College of Medicine talked about the significant disease burden experienced by patients with migraine even as therapeutics have advanced for the condition. [WATCH TIME: 8 minutes]

WATCH TIME: 8 minutes

"We expected that those with previous high frequency migraine and acute medication overuse, who were currently having reduced frequency of headache days and migraine days as well as acute medication days, would have less burden of disease, improved quality of life, better treatment and perception of their [healthcare provider] and patient communication, but we didn't.”

Migraine, a disabling neurologic disease, is a condition that can waver over time for patients in terms of severity, frequency, and acute medication use. Recently published in The Journal of Headache and Pain, responses from an online, US-based survey showed that apart from optimization of acute medication, medical interventions did not significantly differentiate between individuals with current vs previous high-frequency headache/migraine and acute medication overuse (HFM+AMO).1 Known as the Harris Poll Migraine Report Card, the current preventive pharmacologic treatment use was reportedly low (15-16%; P >.01 for current vs previous) in both groups. Additionally, more than one-third of both groups wished their healthcare practitioner (HCP) better understood their mental/emotional health (current, 37%; previous, 35%; P >.01) and 47% to 54% of respondents worried about asking their HCP too many questions.

Conducted by lead author Amaal Starling, MD, FAHS, FAAN, these results signify that there is a lot of room for improvement in the current standard of care for migraine. Starling, an associate professor in the department of neurology at Mayo Clinic College of Medicine, recently sat down with NeurologyLive® in an interview to discuss the main findings of the survey, and why the results came as a surprise. In addition, she spoke about the potential barriers identified in communication between healthcare professionals and patients with migraine.

1. Starling AJ, Cady R, Buse DC, et al. Harris Poll Migraine Report Card: population-based examination of high-frequency headache/migraine and acute medication overuse. J Headache Pain. 2024;25(1):26. Published 2024 Feb 26. doi:10.1186/s10194-024-01725-2
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