How Has Migraine Research Changed?

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I think as we begin to understand the genetics, and how people vary from one to the other, and how we begin to understand how your chemistry causing migraine and my chemistry causing migraine may be different. We'll be able to individualize headache therapy in a way we've never done it before. And then we are always looking at new targets for therapy.

And as we understand the physiology better and better. How do different cell populations of the brain act in a migraine. We may be able to see new targets of therapy that we have not yet imagined. And then maybe at some point, we'll talk about genetic manipulation. Perhaps we'll understand how we can fix your's or my genetic causes of migraine in a way we'd never done before. That may be a tricky business.

It may not be something we want to deal with. We often explain migraine to people as an excitable brain. I told you before that 18% of women, 6% of men have migraine. One of the things you learn in medicine is, when change is really common, there is usually something good about them. For example, sickle cell disease, a terrible condition, hardly imagine if there's anything good about it.

People with sickle cell disease are immune to malaria. So if you happen to grow up in Africa, in high prevalence region for malaria, if you have that genetic make up, that maybe a good thing. Well, people with migraine have this kind of hyper excitable brain, they kind of have a great brain. Maybe it's a better brain than average, maybe that's how they were kept alive when animals might have eaten their non-migraine counterparts.

That hyper alertness and ability to do things often better than others may have an evolutionary advantage, and maybe when we fix it, we leave those migraineurs as people without headache, or dull, boring, ordinary people. So be careful what you wish for.