The Norwegian Centre for Headache Research (NorHEAD) saw its official opening on September 1st, 2022. NorHEAD has a mandate to provide new, trustworthy treatment for patients suffering from headache. The centre will accomplish this through ground-breaking science resulting from patient-focussed clinical trials, data collection and database management, along with new machine learning models and AI to assist in diagnosis. Following its successful opening ceremony, attended by both partners and international collaborators, the centre has now been fully operative for just over four months. Several main activities were launched in parallel and have already produced early results during the final quarter of 2022. Among this, two clinical treatment studies were initiated relating to tension-type headache and episodic migraine, as well as one industry-sponsored study on medication-overuse headache. The database fundament hosted on HUNT-Cloud has been established wherein over 16,000 variables have been identified from pre-existing and varied register sources. Three international guest professors of global recognition have been engaged contractually, including Prof. Matharu, UK; Prof. May, Germany; and Prof. Dodick, US. The centre's Board of Directors was established, and held its first board meeting in November to review budgets and plans for 2023. In addition to this, a Scientific Advisory Board with five expert members has also been established. Within the administration all eight Operational Units are operative, ranging in scope from planning for the adoption of research and treatment results within the health care sector, patient collaboration, coordinating with industry and innovation techniques, communication, financing and centre management. Active working groups and routines are now in place. The headache patient association, Hodepine Norge, has been fully integrated as partner and commenced the process of preparing an ethical guidelines document. This partnership has also resulted in collaborations within public arenas and awareness building including the political arena Arendalsuka during August 2022, and NorHEAD's health professional conference Trondheimskonferansen, during December 2022. Patient-focussed activities have been planned for the first and second quarters of 2023, while user-representative perspectives have been included in separate projects. Within less than six months NorHEAD has submitted 15 applications for funding and received positive confirmation for funding for seven grants. NorHEAD was recipient of the prestigious Onsager Fellowship award, which will be used to strengthen research on 7-Tesla MR spectroscopy, on one of the world's 70 7-Tesla machines in use. A further 6 national and international applications are currently awaiting decisions. Norway has submitted a letter of intention to apply for EU Horizon Europe financing, and is currently building an international consortium for a call deadline of April 2023. NorHEAD partners have presented at larger international symposiums including MTIS 2022 in London, UK and will have four presentations at the European Headache Congress in Vienna this December. Several lectures on NorHEAD topics and the research centre itself have been held in Norway, Sweden and Denmark. NorHEAD has also arranged Trondheimskonferansen this past December 1st, a national headache conference with more that 100 registered participants. Through strategic and coordinated communication initiatives NorHEAD has been covered in 42 print articles and news media broadcasts in Norway. Several journal articles have been published, where one particular paper with the main author from NorHEAD, received extensive international media coverage and was mentioned in 755 media outlets.
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.