Highlights from AHS 2015: cGRP, Neuroimaging Pique Interest

The meeting was abuzz with excitement about a new potential treatment targeted directly at migraines.

The American Headache Society Annual 57th Scientific Meeting recently concluded in Washington, D.C., with thousands of leading thinkers in the field present to share their latest research and thoughts on the future of headache medicine. Headache wasn’t just the talk of the town in D.C. — in fact, migraine is now the most commonly discussed disease on Twitter!

There were many highlights over the four-day scientific meeting, including a presentation made by Zahid Bajwa, MD, the director of the Boston Headache Institute at Boston PainCare, who spoke on the interface of chronic headache, chronic pain, and medication overuse. He discussed nerve blocks as an alternative to the use of opiods, noting that location and volume are key elements to a successful block. He believes that neuromodulation is an important avenue of treatment for chronic pain and recommends 6 cc of bupivicaine in five sites for a typical occipital nerve block — higher than most practitioners are using now.

Among the scientific paper presentations, there were a number of new and interesting studies presented, including the high overlap of insomnia in patients with migraine, presented by Min Kyung Chu, MD, as well as results from the Study of Women’s Health Across the Nation (SWAN), presented by Jelena Pavlovic, MD, PhD of the Montefiore Headache Center. Her results highlighted her continuing work on the interplay of estrogen and migraine, particularly examining the estrogen withdrawal patterns in women with and without migraine. Bruce McEwen, MD, of Rockefeller University, gave a fascinating talk on the actual physical changes that take place in the brain under stress. He described how certain areas of the brain, including the hippocampus, can shrink — impacting mood and pain — while exercise can help to restore these areas and encourage neurogenesis.

There were also a number of awards given out during the meeting, including scholarships for new investigators in the field of headache medicine. Todd Schwedt, MD, a headache expert from Mayo Clinic in Arizona, received the Harold G. Wolff Award for his research on the “Accurate Classification of Chronic Migraine via Brain Magnetic Resonance Imaging,” published in the June 2015 edition of Headache-The Journal of Head and Face Pain. During his presentation, he described the need for a biomarker for migraine and discussed the changes that he found in the brains of those with chronic migraine.

One of the most talked about topics at the meeting was the possibility of a new type of preventive designed specifically for migraines, known as calcitonin gene-related peptide (cGRP) antibodies. Peter Goadsby, MD, PhD, Chair of the Scientific Program for the meeting, noted that this is a “transformative…development” for migraine.

There are currently four pharmaceutical companies in the development and testing phase for cGRP medication and so far, the data seems to be promising. For instance, data presented by Marcelo Bigal, MD, a researcher at Teva Pharmaceuticals, one of the companies developing the medication, showed a significant reduction in the number of headache hours, which compared two doses of the medication to placebo.  Although it will be some time before cGRP medications are approved for use, there is much anticipation and excitement about a medication made specifically for migraine.

Other important topics discussed at AHS 2015 included the growing field of pediatric headache medicine and treatments for medication overuse headache.

For more coverage of AHS 2015, go here.