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BOSTON – During a presentation at the 59th annual scientific meeting of the American Headache Society, Michael Oshinsky, PhD, program director in systems and cognitive neuroscience at the National Institute of Neurological Disorders and Stroke (NINDS), urged the audience of clinicians, researchers, and clinician-scientists to submit grant applications to the National Institutes of Health (NIH), as very few are submitted in the field of migraine and headache research.1
The NIH’s budget for fiscal year 2017 for pain research (including research on headache and migraine) is approximately $475 million.2 This funding aims to provide fundamental knowledge for the understanding of these conditions, which can then be translated into treatments. The vast majority of these funds are allocated to research project grants, which are investigator initiated. Small amounts are dedicated to research centers – large programs instituted by Congress for cross-cutting areas of the Brain Initiative. The NIH itself provides about 90% of all funds for research. Out of all federal grants, approximately 40% are for basic research, 42% for clinical research, and 18% for translational research. Among supported grants, mechanistic studies of pain or pain in migraine represent about 40%, and clinical transition studies about 18%, so that more than 50% of funding is dedicated to mechanistic studies and their translation to the development of new therapeutics.
This vision and direction for pain and migraine research – and dedicated funding – stems from Congress, other agencies, and outside influences that provided recommendations for pain research. Portions of the Affordable Care Act urged to create an interagency pain research coordinating committee. The Institute of Medicine (now, the Health and Medicine Division of the National Academies) produced a report that was based on epidemiologic and basic science data in pain and migraine research; this report indicated that 100 million Americans experience chronic pain, thus triggering other large-scale initiatives.3
Among those initiatives, the Federal Pain Research Strategy, which was published in early 2017, was formulated based on input from patient advocacy groups, physicians, and researchers, and was allowed a period of public review from May 25, 2017, to June 6, 2017. This document lists priorities that should be emphasized in the pain field going forward, including migraine and headache, and focuses mainly on the exploration of biological targets, screening tools, and outcome measures; optimization of public health strategies; and patient education on pain management.
NIH, and NINDS in particular, provides a lot more than funding – a point that Dr Oshinsky sought to emphasize. “The agency looks for gaps or unmet needs,” he added, “to see where their resources could be used, and [as an example] it was found that there was a lack of knowledge in migraine among the 10- to 15-year-old age group that has access to technology.” A smartphone app geared at this age group and named “Migraine Coach” was therefore developed by the NIH and is now available for purchase. The app seeks to gather data in an endeavor to learn more about migraine in this population and how to handle it.
Another initiative Dr Oshinsky mentioned is the NINDS Common Data Elements, addressed to clinical researchers, in an attempt to help them capture common data so as to facilitate comparison between clinical trials. The website is in its second edition, and the Headache Common Data Element is currently under public review until July 10, 2017. “If you are doing clinical research in the headache or migraine field, you should look at this website and use this federal resource, to help you get your trials started quicker,” urged Dr Oshinsky. Sections of the Common Data Element include biomarkers, imaging, and demographics. “These projects are very important,” he added. When the NIH sees communities working together to achieve these common goals for research, that gets their attention,” he remarked.
“By looking at better models, new treatment targets, drug discovery, we can increase the funding for migraine research,” added Dr Oshinsky. NINDS has whole divisions dedicated to the translation of basic science into clinical treatments. Support – with specific funding mechanisms all along the way – is available for companies or academics to help them bring their potential treatments to phase 1 studies. As an example, Dr Oshinsky detailed his grant portfolio at NIH, which includes 160 grants from 110 principal investigators, of which 36 are related to migraine and headache research, 12 are translational, and 2 are blueprint therapeutic grants.
“The NIH and NINDS have programs to encourage people to submit applications in migraine and headache research.” There has been a change that will benefit the migraine field, specifically in the context of review: previously, somatosensory and chemosensory grants were reviewed together. For the next review session, which will take place in October 2017, there will be a specific NIH study section on somatosensory pain systems.
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- Oshinsky M. NIH roadmap for migraine research. Presented at: The American Headache Society 59th Annual Meeting; June 8-11, 2017; Boston, Massachusetts.
- Estimates of funding for various research, condition, and disease categories (RCDC). National Institutes of Health. Available at: https://report.nih.gov/categorical_spending.aspx. Accessed: June 9, 2017.
- Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Mil Med. 2016;181(5):397-399.