Meet the Expert: Messoud Ashina

Messoud Ashina MD PhD DMsc is Professor of Neurology, Danish Headache Center and Department of Neurology, University of Copenhagen, and has been involved into headache research since 1995. He completed his PhD in headache science focusing on tension-type headaches. Since 2006, he has been working on migraine and, in particular, experimental models of migraine.

We had the pleasure of speaking with Professor Ashina about his work, some of the innovations in patient management and his hopes for the future for helping sufferers of this debilitating condition.

Professor Ashina’s research focuses on experimental models of migraine in humans. This work involves provoking a migraine attack in patients and then trying to ascertain the specific biomarkers involved in induction with a view to developing drugs that can target these markers. In addition to his basic scientific research, he is also a lead investigator on clinical trials yet still manages to practice as a neurologist seeing headache patients.

Professor Ashina described migraine as ‘quite a complicated neurological disease characterised by attacks, and which are paroxysmal in nature and self-limiting’. He explained how typically the disease first presents during the teenage years and then gradually evolves over the following decades but then gradually becomes less severe and less frequent with advancing age. He sees migraine as a ‘fascinating disease to study’ because it is not just a headache but also associated with a sensitivity to light, sound, smell and nausea or vomiting. As a result, he felt that it was important for clinicians to recognise that migraine can be a debilitating disease. In many instances, during an attack, patients tend to either stay in bed or remain sat at home since the slightest movement ‘aggravates the pain’. Both the headache and sensitivities have contributed to the archetypal depiction of a migraine sufferer as someone who remains in a darkened room during their attack, for anywhere between two to three days. 

Despite much research time and effort spent trying to understand the condition, Professor Ashina concedes that we are still very much in the dark as to why a migraine starts. He believes that the underlying cause most likely involves some form of complex communication between areas within and outside of the brain that which will ultimately ignite a migraine attack. Furthermore, because attacks naturally abate after a few days, either the same, or another communication pathway, transpires to somehow extinguish the migraine flame. Thus, exactly how a migraine starts and stops remain some of the biggest unanswered questions in migraine research.

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