Migraine

Migraine is a common disabling, episodic brain disorder, typically characterised by recurring, usually incapacitating attacks of severe pulsating head pain and associated symptoms such as nausea, vomiting, photophobia and phonophobia, and changes in mood or energy levels (migraine without aura).1 Migraine attacks last between 4‐72 hours (median one day).2,3 In one‐third of patients, attacks are associated with neurological aura symptoms (migraine with aura).3 Migraine is a clinically heterogeneous disorder. None of the features occur in all patients who meet a definition of migraine, and no single symptom is required for diagnosis.1

Migraine is largely neglected

Migraine is one of the most prevalent, disabling, misdiagnosed, and undertreated disorders, and the associated economic burden to society is astronomical. Yet, migraine is a misunderstood, underappreciated, and largely neglected phenomenon throughout the world. The near ubiquity, the broad public familiarity, and the perceived near‐absence of fatal complications, combined with a century of direct‐to‐consumer promotion of inexpensive but mostly ineffective over-the-counter analgesics, has reinforced an impression that migraines are only a minor problem, except for those with a low tolerance for pain.

Despite the high disease‐associated disability and socio‐economic burden, migraine is stigmatised and dismissed,4 and is dramatically underfunded, in particular when compared to other disorders which are much less frequent and are associated with less disability and socio-economic burden. For example, in relation to National Institutes of Health (NIH) funding (USA), migraine is by far the lowest-funded disorder relative to disease burden―i.e., inspection of the below figure shows migraine is the largest vertical distance below the ‘Predicted Funding’ line—and is funded at approximately one-tenth to that of other disorders with similar or less disease burden!5

Sadly, the global underfunding of migraine continues to this day.

IHGC members are committed to improving this situation; however, we need your support to raise the profile and encourage industry and government to better prioritise medical research funding and develop more stable funding sources for migraine and other headache disorders.

References

1. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 24(Suppl 1), 9-160 (2004).

2. Jensen, R. & Stovner, L.J. Epidemiology and comorbidity of headache. Lancet Neurol 7, 354-61 (2008).

3. Launer, L.J., Terwindt, G.M. & Ferrari, M.D. The prevalence and characteristics of migraine in a population-based cohort: the GEM study. Neurology 53, 537-542 (1999).

4. Shapiro RE. Lagniappe: the impact of headache disorders in America. Headache. 2013 Jan;53(1):196-204.

5. Moses H 3rd, Matheson DH, Cairns-Smith S, George BP, Palisch C, Dorsey ER. The anatomy of medical research: US and international comparisons. JAMA. 2015 Jan 13;313(2):174-89.