Migraine is recognised as one of the most high-burden, under-researched medical conditions.
Existing treatments do not provide relief for everyone, and do not target the range of symptoms associated with migraine including one of the most debilitating symptoms - extreme fatigue.
In this project, Dr Holland and team will advance our understanding of the neurobiology of migraine, focusing on the non-pain, non-headache elements, to drive the development of new treatments.
Following rigorous assessment as part of our national, competitive grant round, this project was recommended for its strong potential to advance knowledge towards the development of new treatments in this area of great clinical need.
Migraine affects more than a billion people globally and around 11 million in the UK, making it one of the most common brain disorders worldwide. It is recognised as one of the most high-burden, under-researched medical conditions.
Migraine is a complex condition with a variety of symptoms including not only a severe headache, but also nausea, disturbed vision, and increased sensitivity to light and sound. Although there are treatments that are effective for some people, it is generally accepted that these work in around 50% of people, 50% of the time.
For those who struggle to achieve relief from symptoms, the impact on quality of life, including work, family and social life, can be huge. New treatments are needed, to help reduce this burden.
Prior to headache onset, people with migraine report a variety of signs that warn of an attack. These include a variety of physical and mental changes including, most commonly, extreme fatigue. This is a highly debilitating but under-recognised symptom of migraine.
During this pre-headache phase, key areas deep in the brain called the hypothalamus and brainstem have been shown to become overactive. It is thought that this overactivity may underpin these early symptoms and initiation of the migraine attack, with the presence of extreme fatigue suggesting the involvement of brain networks that normally function to maintain alertness and cognitive abilities.
In this project, Dr Holland and his team are setting out to identify the key pathways in the brain that are responsible for fatigue and pain in migraine, and to determine whether it is possible to normalise their function and discover new therapies to reduce fatigue and stop the migraine.
Most current migraine therapies target the headache element of migraine, designed and assessed on their ability to block the pain. headache. Evidence suggests that they can be more effective when used early in the attack, when the pain is mild.
This project takes a new approach by targeting the underlying cause of the earliest symptoms of migraine, including extreme fatigue. In doing so, the team hopes to develop new therapies with the potential to normalise the early brain changes that give rise to the migraine attack, stopping the migraine in its tracks rather than simply masking the pain. By addressing the debilitating fatigue element of migraine, this approach has the potential to make a substantial difference to those affected by migraine.
Importantly, the proposed work will decisively advance the entire field of migraine and headache research because it takes migraine neurobiology further than just defining migraine as pain attacks. External reviewer
Dr Philip Holland is an internationally recognised expert in migraine research. He leads a lab focused on understanding the mechanisms that underlie the symptoms of migraine and other primary headache disorders, with the ultimate aim of developing safe and effective treatments. He works closely with clinical colleagues to ensure that his research has clinical relevance.
He is collaborating on this project with Dr Rolf Fronczek, a neurologist from the Leiden University Medical Centre in The Netherlands, who has aspecial focus on the treatment of headache and sleep disorders.
Find out about our other research in this area:
