Abstract
The science of headache has seen remarkable progress from a time when evil intracranial spirits was the pathophysiological construct to the present day, when the genetic and molecular basis of migraine is coming squarely into focus. Advances in our understanding have translated into advances in treatment and better care and quality of life for patients.
A PubMed search today for “migraine” will generate some 26,715 papers—at least double the number generated in 1999. While advances in the scientific methodology of both animal and human research is impressive, the complexity of the research platforms currently used today and the ability to analyze, interpret and understand the veracity as well as the clinical and scientific implications of the data that are generated may be accessible to only a limited number of those with special expertise in a particular area. This of course is why most readers justifiably rely on the process of peer-review—manuscripts that have mastered this hurdle have demonstrated a certain degree of scientific merit. But a true academic exchange requires the understanding that even if a manuscript mastered this hurdle and is published, this does not protect the reader from thinking and systematically exercising a critical eye. Most readers would therefore like to better understand the methods used and a guide to better understand both the value and the possible limitations of a given study.
This thought was the condensation point to develop a specific series of lectures at the International Headache Congress 2011 in Berlin that was entitled: Pearls and Pitfalls in Headache Research. The idea was for each of the major scientific disciplines to raise awareness of some of the pitfalls and facilitate the ability of clinicians and scientists to critically appraise the work to determine its scientific merit and potential clinical implications.
This symposium, although focusing on scientific methods, was well attended and witnessed some particularly lively discussions. Because of this success, we asked the speakers of this symposium to summarize their area of expertise for a special issue with the title “Pearls and Pitfalls,” covering issues such as Neuroimaging, Animal and Human Research Models, and Genetics. The vision was to have some of the leading scientists in the field of headache research share both the scientific pearls—outstanding and valuable knowledge gathered from their respective fields—as well as the scientific pitfalls—deficiencies in methodology or data analysis and interpretation that may diminish the scientific rigor and potential impact of the work.
We are very grateful that all of the authors unanimously and spontaneously agreed to work on this issue and we knew that none of them realized at that point just how much work this would entail. But this issue certainly reflects the current knowledge of what we have learned over time from headache research and does so from the perspective of the methods. Given the significant advances in so many areas of headache research, this supplement itself has the limitations that not all areas could possibly be covered within the pages of a single issue. In addition, each paper reflects to some degree the personal view of the authors. This is particularly important as every paper gives some advice for future studies, especially what a given method or study design should provide to deliver meaningful results. The idea is to give the reader a road map of what to look for (i.e. how many patients make a meaningful number for a given neurophysiological, imaging, or genetic study) and it is self-evident that particular studies or scientific questions will perhaps deviate from these suggestions. We are thankful to Dr Dahlof for his authoritative review of the ethical issues in headache research that precedes the methodological chapters, as this is certainly the starting point of all scientific endeavors. I am also personally (Dodick) very grateful to Professor Arne May for his vision, hard work, and leadership in bringing this special issue to fruition.
We believe this special issue will be highly interesting for everyone involved in headache medicine and research and hope it may serve as a useful guide for younger researchers as they embark on their career in headache research.