Project ID iCASE2024_08_NS-MH


Co Supervisor 1A Wolfson Centre for Age-Related DiseasesWebsite

Co Supervisor 1B Wolfson Centre for Age-Related DiseasesWebsite

Additional Supervisor Rob Music

Partner The Migraine Trust

Targeting non-pain symptoms in migraine: Opening new avenues in treatment

Migraine is a disabling disorder that significantly impacts quality of life, with recurrent attacks of severe headache. Attacks are intrinsically linked with head pain; however, patients commonly report several non-pain symptoms hours to days before the headache that offer novel insight into how attacks may start. Despite considerable success, most therapies focus on targeting the pain of migraine, with little attention given to this early premonitory phase. The understanding of which, has the potential to uncover novel mechanism-based therapies, that could act to target the underlying biology of migraine, rather than masking the pain. The proposed research will aim to reverse translate the known clinical phenotype of premonitory symptoms in patients, to enable the underlying biology to be studied in clinically relevant animal models, where novel therapies can be tested and optimised for future clinical trials.

The project will:

1. Use cutting edge in-vivo imaging and recording methodologies to investigate the underlying biology of non-pain symptoms in migraine.

2. Explore intervention strategies (e.g. pharmacology/chemogenetics) to uncover novel therapeutic targets that can then be translated into the clinic to reduce the significant therapeutic-gap in migraine.

3. Work with the Migraine Trust, to include people with a lived experience of pain in the research (focus groups) and to maximise dissemination and impact, key skills for research advocacy.

Key translational aspects will be explored via clinical collaborators as appropriate. The successful student will develop state-of-the-art in-vivo (e.g. electrophysiology, chemogenetics and imaging), ensuring they master a number of highly desirable specialist skills. A unique aspect of this project is the opportunity to work with a leading patient advocacy group (the Migraine Trust) to develop patient outreach and educational programmes that will maximise the impact of the proposal. The student will join the world leading Wolfson Sensory Pain and Regeneration Centre (SPaRC) at King’s.

Representative Publications

1. Investigating the relationship between sleep and migraine in a global sample: a Bayesian cross-sectional approach. Stanyer E.C. et al. J Headache Pain. DOI: 10.1186/s10194-023-01638-6.
2. The selective 5-HT1F receptor agonist lasmiditan inhibits trigeminal nociceptive processing: Implications for migraine and cluster headache. Vila-Pueyo, et al. Br J Pharmacol. DOI: 10.1111/bph.15699
3. Differential medication overuse risk of novel anti-migraine therapeutics. Saengjaroentham, C. et al. Brain. DOI: 10.1093/brain/awaa211.
1. Pathophysiology of Migraine: A Disorder of Sensory Processing. Goadsby, P.J. et al. Physiol Rev. DOI: 10.1152/physrev.00034.2015.
2. Brain activations in the premonitory phase of nitroglycerin-triggered migraine attacks. Maniyer F.H. et al. Brain. DOI: 10.1093/brain/awt320.
3. Safety, tolerability, and efficacy of zavegepant 10 mg nasal spray for the acute treatment of migraine in the USA: a phase 3, double-blind, randomised, placebo-controlled multicentre trial. Lipton R.B. et al. Lancet Neurology. DOI: 10.1016/S1474-4422(22)00517-8.