News from the Scientific Meeting Part I

I have just a moment to give a summary of this year’s scientific meeting of the American Headache Society.  I know that most of my patients wish that I would come home with radically and curative treatments for headache. But, I don’t think that will ever happen. On the good news side progress is continuing to be made in the understanding of headaches and eventually effective treatments.

I often describe to patients the concept of the brain, or head for that matter, being like a laptop computer. Once it is dropped on the floor, or develops some other glitches, it may look normal (patients having normal MRIs) but it isn’t working normally.  But having just sat through hours and hours of lectures by very bright scientist, I think I need to adjust my model.

Think now of a huge, NFL-sized, football stadium filled with about a hundred million laptops.  Between the laptops are an array of wires, about two billion of them, running in all directions.  The brilliant researchers have walked into this 50 foot pile of laptops only about ten feet from the edge and have straightened out about a few thousand of the wires. This is how complex the head and brain are.  But they are making progress.

I am sorry to say that not one new treatment was disclosed in all the lectures and research posters.  But there were some provocative ideas, a few I want to share.

An incredible study was shared on the role of placebos in treatment of pain.  The placebo effect is far more complicated than just wishful thinking. The brain participates in a very deep and real way, releasing endorphins and other helpful neuro-transmitters.  It appears that the effectiveness of our medication treatments for headache may be 50% influenced by the mental attitude of the patient. If the patient believes that the medicine will work, then it has a 50% better chance of working. If the patient believes that it won’t work or that they will have side effects, then there is a much greater chance their beliefs will come true.

A group from Brazil presented a study trying to show that wine is perceived to be a headache trigger, but in a blinded (patients didn’t know they were getting wine) didn’t seem to provoke headaches. Again, it may be a mental belief thing. If a patient believes that wine will provoke a headache, then it will.

A Missouri once again is trying to show that daily intake of chocolate may in fact be helpful in preventing headaches.  This flies in the face of the information that we have given patients for decades that eating chocolate is a headache trigger. So go figure.

At the last scientific meeting it was stated that there was no evidence that allergies or sleep problems provoke headaches.  New evidence, presented this week, showed that chronic headache sufferers did have higher levels of allergy indicators in their blood than controls but we don’t know what that means yet.  There was evidence presented that sleep apnea does cause a unique morning headache but not a worsening of migraine .  I will be back with a few more news items as soon as I have another five minutes to write.