The Norwegian Centre for Headache Research (NorHead) has had a hectic and productive first year. A lot of effort has been put into infrastructure development, including NorHead Research Register. Thirty papers have been published, and the center has has several activities for health personnel and the general public. The Patient Conference gathered 250 participants. NorHead has in 2023 been awarded 50 million NOK in new research funding, and the center is in addition coordinator for an EU application. A research highlight is that we through register research has identified that statins probably have an anti-migraine effect (drug repurposing). The results were presented at the international headache conference (IHC) in Seoul in Sept. and the presentation was also selected for the "Highlight" session. This will be further tested in two trials (RCTs) in 2024, where we will invite 750 patients from all over Norway to participate. The CandMig study with candesartan as a migraine prophylactic ended its inclusion with patient number 450 in November and the Nurse Intervention Trial, that will include 400 headache patients, to test for better treatment and follow-up, was initiated. Publications on safety on use of medication used as migraine prophylaxis during pregnancy led to new European Guidelines on use of these drugs. Research from NorHead led to a new spin-off company in 2023.
Headaches disorders are among the most common and disabling diseases worldwide. Yet, they are poorly understood and under-emphasized in government policies, with few novel therapeutic options being advanced. At present, there are few initiatives at an international scale aimed at improving patients' situations. The 2018 National Brain Health Strategy identified headaches as a topic with large unmet needs. Thus far, little has been done. We have identified three main research areas, directly addressed by the secondary objectives, that together serve the overall objective and ambition of NorHEAD.
Within the first research area, we will conduct clinical trials leading to evidence-based new and improved treatment options for headache disorders. We will perform an ambitious large-scale pragmatic study with an aim to construct a decision-support system for choosing effective migraine treatment. The trial will be complemented by a meticulous collection of paraclinical biomarkers to facilitate neurobiological understanding and treatment optimization. Moreover, we will establish new treatments for the neglected pediatric migraine population, develop a new eHealth intervention for medication overuse headache, investigate and establish non-pharmacological interventions including biofeedback and structured lifestyle interventions, develop and establish new botulinum toxin treatment paradigms for chronic migraine and tension-type headache, and establish new surgical options for chronic cluster headache and refractory trigeminal neuralgia.
Within the second research area, we will exploit the rich health register databases in Norway, using unique epidemiological approaches to identify demographic and genetic markers of etiology and responsiveness, repurpose drugs and evaluate societal impact.
Finally, we will exploit machine learning to develop prescriptive models, enlighten disease etiology and treatment mechanisms, and enable clinical individualized decision-support tools.