Physicians and scientists from Mayo Clinic's Migraine Research Program are working to better understand, treat and prevent migraines by examining the role of genetics and environment in migraine, and machine learning-driven phenomics.
Migraine is a complex genetic disorder characterized by recurrent, severe headache accompanied by nausea or profound sensitivity to light and sound. Approximately 40 million Americans experience migraine, and the intensity of migraine symptoms can be quite debilitating. Migraine costs the U.S. economy more than $23 billion each year.
The Migraine Research Program at Mayo Clinic focuses on better understanding and treatment of this common, functionally complex and multifaceted disorder. Migraine is challenging to study for several reasons:
- It is a paroxysmal, sudden attack disorder in which there are no neurological symptoms or signs between attacks.
- There is currently no specific imaging test, or biochemical or pathological biomarker to define the disorder as a disease.
- A prominent component of the syndrome is pain, which is subjectively experienced and difficult to assess across multiple patients.
The study of the pathophysiology of migraine has greatly evolved over the last 15 years. The rapid evolution of investigative techniques permits study of migraine with minimal invasiveness in human subjects.
Three areas of rapid progress are investigations focusing on:
- Genetics of migraine.
- Environmental factors influencing migraine.
- Applications for novel functional neuroimaging techniques.
- Multi-omics technique.
- Machine learning focused on patient characteristics.
The Migraine Research Program maintains a growing library on genetic information to help researchers better understand the disorder and is looking for families in which migraines are prevalent to participate. Learn more about the Migraine Genomic Library.
The four phases of migraine are: prodrome, aura, headache and postdrome. Not every person experiences every phase with every migraine.
Migraine is generally episodic, does not cause death and is not contagious. Consequently, migraine research is the least publicly funded of all neurological illnesses relative to its economic impact.
Migraine affects some cross sections of the population more than others. In particular, migraine is three times more common in women than in men. Although migraine affects all ages, it usually begins in adolescence and is most disabling for individuals between 35 and 45 years — typically a highly productive period of life.
Migraine can be episodic, occurring only a few times a year, or chronic. In chronic migraine, headaches occur more than 15 days per month. Treatment of chronic migraine is problematic because when used more than a few days a week, acute therapies worsen the headaches in most people. This underscores the importance of finding effective prophylactic treatments that lower attack frequency.
More than one-third of people with migraine experience the aura — one or more transient sensory disturbances that may include geometric visual hallucinations, loss of vision, spreading numbness and tingling on one side of the body, language disturbance, and muscle weakness on one side of the body that ranges from mild clumsiness to paralysis.
The director of the Migraine Research Program is Fred (Michael) M. Cutrer, M.D., a neurologist specializing in headache medicine at Mayo Clinic in Rochester, Minnesota. Dr. Cutrer is a professor of neurology at Mayo Clinic College of Medicine and Science, and also serves as chair of the Division of Headache for Mayo Clinic's Department of Neurology.