Abstract
My vision
Reading Dr. Livening’s book “On Megrim, Sick Headache,” published in 1873, compelled me to the field of migraine, which I joined in 1996. Influenced heavily by his detailed description of the many aspects of migraine, I became fascinated with the complexity of the disorder and the various paths it travels in the brain. Eighteen years later, I am more absorbed than ever in translational research on the different symptoms that accompany migraine. Being funded by the NIH, my translational research operation focuses on photophobia, peripheral and central sensitization, inflammatory and immune responses, post-traumatic headache, and endothelial dysfunction. This research takes us into the retina, hypothalamus, thalamus, cortex, spinal cord, peripheral nerves, meninges, and bone marrow. I no longer believe it is possible to hit a grand slam and identify one factor, one mechanism, or one brain area that “causes migraine.”
Maybe most critical to my current thinking is the recognition that the direction of translational research in headache should be reversed. Instead of using the traditional “bench-to-bedside” approach, it may be more productive to adapt a “bedside-to-bench” approach whereby all questions that can be answered in humans should be answered in humans, and all that is required from animal studies is to test hypotheses that have been defined in patients but could not be tested due to ethical limitations involving high risk/low benefit ratio. Last year, I was honored to be elected to the IHS Board of Trustees. As a Board Member, I look forward to fostering communications among those working to push the envelope on innovative research headache.
John Hedley-Whyte Professor of Anaesthesia and Neuroscience, Harvard Medical School
Vice Chairman of Research, Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center
Academic Director, Comprehensive Headache Center, Harvard Medical Faculty Physicians
Boston, MA, USA.
Building bridges
The Dutch are famous for their water engineering. We need sophisticated water ways and dikes to keep the water out, since one-third of the country is below sea level. To cross these water ways we have an excellent network of bridges, so I was born and raised with the importance of bridges.
My career with IHS started with the Juniors committee in 2001, building a bridge between trainees/residents and established headache scientists. We started organising the Juniors forum and provided travel grants. In 2010, I joined the IHS Board of Trustees as past Chairman of the Juniors committee and current Chairman of the Education committee.
One of the main aims of the IHS is to improve headache education worldwide. Based on the “Atlas of Headache Disorders and Resources in the World 2011”, the level of headache care has improved quite substantially, but there is still little attention on headache education in many parts of the world. In order to bridge these gaps between countries with different levels of development, IHS spends more than US$ 100,000 every year through fellowships, visiting professor programmes and a headache pioneer programme.
A third important bridge is between different resources of headache education. At the moment, the IHS is actively building an online headache library and has several educational programmes. The online learning centre can be found on the IHS website and contains educational material like book chapters, slide series and congress posters. Educational programmes are continuously provided, for example, the “headache master school”. And finally, to set a standard for headache education, the IHS has created a Core Curriculum for headache.
Neurologist, St. Elisabeth/Tweesteden ziekenhuis, Tilburg Headache researcher, Leiden University Medical Centre, Leiden, the Netherlands.