A Clinical Preview of 2024 for Headache and Migraine: Brian Grosberg, MD, FAHS

WATCH TIME: 7 minutes

"Over the last quarter century, crucial data from human and animal models have enhanced our understanding of migraine mechanisms, leading to the development of monoclonal antibodies that block the calcitonin gene related peptide signaling pathway."

In 2024, headache medicine is anticipating new research updates and pending approvals on potential therapies for headache disorders, including migraine, status migrainous, posttraumatic headache, and others. Headache, a common ailment that afflicts patients worldwide, can be debilitating impacts on quality of life and productivity of those with the condition.¹ Over the recent years, the medical community has made significant strides to understand the complexities of headache, with a greater focus on novel approaches for diagnosis, treatment, and management.

Investigators are continuing their pursuit in 2024 to understand more of the determinants, interactions, and the biological mechanisms of headache to uncover innovative and better management strategies. In a recent editorial published in Frontiers in Pain Research, researchers showcased some of the latest advancements in the field, shedding light on various aspects of the condition and their implications for care.² These included calcitonin gene related peptide, a peptide that participates in the transmission of pain signals, and the new class of therapies that prevent migraine attacks. As more new therapies become introduced for patients, researchers are raising questions about real world experiences, as well as intentional and unintentional effects of combinations and interactions.²

Brian Grosberg, MD, FAHS, director of the Hartford healthcare Headache Center in Connecticut, recently sat down with NeurologyLive® in an interview to share his clinical perspective on the hot topics of headache medicine for 2024. Grosberg, also a professor of neurology at the University of Connecticut School of Medicine, talked about how pituitary adenylate cyclase-activating polypeptide (PACAP) and oxytocin represent novel therapeutic approaches in treating migraine and its potential benefits for patients. He also spoke about the concerns raised by headache specialists about the increasing difficulty in obtaining new migraine treatments, and how this might impact patient care. Additionally, he discussed how glucagon-like peptide 1 receptor agonists, primarily used for weight loss and diabetes, might play a role in altering migraine epidemiology, and what implications this might have for patients with chronic migraine.

REFERENCES
1. GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 [published correction appears in Lancet Neurol. 2021 Dec;20(12):e7]. Lancet Neurol. 2018;17(11):954-976. doi:10.1016/S1474-4422(18)30322-3
2. Giani L, Yalinay Dikmen P. Editorial: Emerging trends in headache. Front Pain Res (Lausanne). 2023;4:1288707. Published 2023 Oct 19. doi:10.3389/fpain.2023.1288707