Neurology Central

Migraine and cluster headache: understanding, advances and needs

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Peter Goadsby is currently the Director of the National Institute for Health Research (NIHR) Wellcome Trust King’s clinical research facility (London, UK), as well as a Professor of neurology at Kings College London (UK) and a neurologist at Kings College Hospital (London, UK); he also currently holds a chair in neurology at the University of California, San Francisco (CA, USA). He has had the pleasure of working across the world, developing his interest in and researching headache conditions. Institutions he has worked at have included; The University of New South Wales (Sydney, Australia), The National Hospital for Neurology and Neurosurgery (London, UK), The University of California (USA) and University College London (UK).

We recently caught up with Peter to discuss his extensive research in headache disorders, including the pathophysiology of headaches, rare forms and research needs within the field.

What first sparked your interest in headache research?

I carried out my medical training at the University of New South Wales in Sydney where the Professor of Neurology was James W Lance, whose interests were migraine and movement disorders. He was a very captivating lecturer and I hadn’t really been interested in anything else that had been taught on the medical course up to that point, but when he gave his migraine lecture I thought it was fascinating.

The explanations for migraine onset that were available at the time seemed silly to me and I mentioned this to Lance. Luckily he took it rather well and told me that if I thought they were so silly then maybe I could help him out by doing some research in his laboratory. When I started doing headache research in the laboratory I thought it was fantastic;  that was the early 1980’s and I’ve been at it ever since. What sparked my interest really then was having a good mentor.

What are some of the current focuses of research in your lab?

My research activities are in two parts, the first is basic science and the second is clinical. In our basic research we’re interested in the physiology and pharmacology of areas of the brain that are capable of modulating or altering nociceptive input. This is because I think that is at the core of migraine.

On the clinical side we’re mainly focused on neuroimaging in migraine and we’re particularly interested in the imaging signatures of the nonpain phases of migraine, for example the premonotory phase, which we think is being relatively understudied. I think understanding and getting a grip on the areas of the brain that are involved in migraine is helpful to focus laboratory activities on these influential areas of the brain.

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