NeurologyLive® Year in Review 2023: Most-Watched Headache and Migraine Expert Interviews

In 2023, the NeurologyLive^® team spoke with hundreds of people and posted hundreds of hours of interview clips. The staff spoke with neurologists, investigators, advanced practice providers, physical therapists, advocates, patients, pharmacists, and industry experts—anyone involved in the process of delivering clinical care.

These conversations were had with individuals from all over the world, both virtually and in person. The team attended more than 10 annual meetings of medical societies, each and every time sitting down with experts on-site to learn more about the conversations driving care and the challenges being overcome.

From those in the field of headache and migraine this year, we learned about the challenges in conducting clinical trials among specific populations, mental health's relationship with disease, the current state of emergency migraine care, and many other topics. Thematically, 2023 marked a year of improved understanding of migraine neuroscience and discussions of novel therapeutic approaches.

Here, we'll highlight the most-viewed expert interviews on NeurologyLive^® this year. Click the buttons to watch more of our conversations with these experts.

1. Promise in PACAP Pathway for Treating Migraine: Jessica Ailani, MD

The director of the MedStar Georgetown Headache Center provided insight on the excitement behind PACAP, how it may offer an alternate way of treating migraine, and where research behind it currently stands. WATCH TIME: 4 minutes

"It’s interesting because we’ve been so focused on talking about CGRP, what we haven’t talked about are all our failures. CGRP is the one that kind of made it through the hoops, but there are actually many peptides that have been looked at in the trigger of migraine and involved in the pathophysiology."

2. Reframing the Communication of Lifestyle Changes for Migraine Management: Elizabeth Seng, PhD

The associate professor at Yeshiva University and Albert Einstein College of Medicine explored the challenge of discussing lifestyle changes for patients with migraine, noting that lifestyle modifications can be a valuable addition to migraine treatment. WATCH TIME: 3 minutes

"We think that people with migraine have a disease that is largely genetic, where their brains are a little bit more sensitive to changes and differences in their environment. One of those things is sedentary behavior and lack of physical activity. So, things that are healthy for everybody tend to be even more important and even more beneficial for people with migraine."

3. Proper Ways to Engage Underserved Populations in Pain Medicine: Burel Goodin, PhD

The professor of anesthesiology at Washington University in St. Louis provided perspective on the respect and approach that comes with conducting research in underserved or impoverished communities. WATCH TIME: 4 minutes

"It can take a lot of work before the actual work of the clinical trial can commence, and I think that's often off-putting to a lot of folks to as investigators because they don't necessarily know where to start. When you present it like that, clinicians are like, “I just want to know whether or not my treatment works.” Obviously yes [we want to know to], but this is the foundation for being able to appreciate if it [the thing you’re researching] does or does not work, and why and for whom and under what circumstances."

4. Empowering Primary Care in Migraine Management for Women: Bert B. Vargas, MD, FAHS, FAAN

The associate vice president of neuroscience, US Medical Affairs at Eli Lilly talked about the impact of migraine on women and the importance of primary care in managing this widespread condition. WATCH TIME: 4 minutes

"One contributor is the hormonal differences that women experience that many men do not, which lead them to be more susceptible to migraine attacks during particular times of their cycle. You also see some differences in how women with migraine experience their attacks, or sometimes even get relief from attacks during different periods in pregnancy, or notice a decrease in the number of their migraine attacks even after menopause."

5. Debunking Myths of Migraine’s Role in Dementia: Olivia Begasse de Dhaem, MD, FAHS

The headache specialist at Hartford Healthcare Headache Center emphasized the importance of avoiding unnecessary fear surrounding the potential link between migraine and dementia, as current evidence does not strongly support it being a significant risk factor. WATCH TIME: 2 minutes

"We don't have strong evidence that migraine is a prominent risk factor for dementia. Fear is not productive; rational decision-making is crucial. We should avoid unnecessary scaremongering and have more research conducted to assess its role. Thus, the suggested retrospective cohort study could provide insights into the potential association between early-life migraines and later-life dementia."

6. Advancements and Updates to the Treatment Algorithm of Migraine: Emad Estemalik, MD

The director of the headache section at Cleveland Clinic’s Neurological Institute gave an administrative perspective on the changes to how patients with migraine are cared for, led by significant developments in recent years. WATCH TIME: 4 minutes

"The other element, which we put emphasis on, is that imaging is becoming far more sophisticated. We talk about the 1.5 Tesla MRIs, the 3T MRIs, they keep updating. These additional incredible imaging tools are giving us more information when it comes to secondary headaches."

7. Future Research on Cannabis Use to Treat Migraine: Nathaniel Schuster, MD

The pain management specialist and headache neurologist at the University of California San Diego Center for Pain Medicine discussed the different forms of cannabis and the need to conduct larger, multicenter studies to better understand its effects in migraine. WATCH TIME: 3 minutes

"We need to have some long-term research prospectively following patients to see whether this [cannabis] leads to the development of medication overuse headache, and at what rates."

8. Using a Data-Driven Approach to Assess Clinical Heterogeneity in Migraine: Ali Ezzati, MD

The director of the Neuroinformatics Program at the University of California, Irvine, provided insight on the use of self-organizing maps to cluster different groups of patients with migraine. WATCH TIME: 4 minutes

"Despite how young we look, we both graduated from fellowship quite a while ago. I believe at the time there were 8 or 10 fellowship programs, and now there are over 40. That speaks volumes about how people are realizing the importance and value [in them], particularly in academic centers."

9. Using a Novel Educational Intervention to Improve Overall Knowledge of Headache: Sara Pavitt, MD

The chief of headache at UT Austin Dell Children’s Hospital provided insight on a new series designed to deliver longitudinal comprehensive pediatric headache education. WATCH TIME: 3 minutes

"Headache is the most common neurologic symptom that presents in a physician’s office. Every type of physician, no matter if you’re in neurology or outside of neurology, is going to see these patients."

10. Migraine Vaccine Shows Comparable Efficacy to Monoclonal Antibodies for Migraine Relief: Jean-Cosme Dodart, PhD

The senior vice president of research at Vaxxinity talked about research for a potential vaccine for migraine prevention presented at the 2023 AAN Annual Meeting. WATCH TIME: 6 minutes

"We're very hopeful that UB-313 will go through clinical development smoothly. At the end, we hope to have a safe and well-tolerated vaccine that could complement the available drugs currently on the market and provide the patient with a much more convenient and a much cheaper treatment option."