The Future of Migraine Care: 3 Wishes for Patients from Leading Neurologist and Researcher Peter McAllister, MD

Near the end of 2024, Patient Care© interviewed Peter McAllister, MD, a practicing neurologist and active clinical trial investigator on a wide range of topics in migraine spanning research, discovery, disappointments, and a look ahead to 2025. At the end we asked McAllister to imagine he had 3 wishes for patients with migraine that would come to fruition over the next 10 to 15 years. He explains those wishes and the thought behind them in the short video above.

The following transcript has been edited lightly for clarity and style.

Patient Care: If you were granted 3 wishes for people with migraine to come true over the next 10 to 15 years, what would they be?

McAllister: First, I’d wish for accurate biomarkers that allow us to truly personalize migraine treatment. This would help us tailor therapies to each individual and improve outcomes.

Second, I hope we can achieve what we call 'migraine freedom.' Now, migraine is a chronic disease, so when we say 'freedom,' we don’t mean eliminating every single aspect of it for life—that’s unrealistic. What we mean is freedom from the disability caused by migraine: no longer being unable to pick up your child from school, missing work, or fearing the next attack. It’s about freedom from the side effects of medications being worse than the condition itself.

I think we’re starting to see light at the end of the tunnel with highly targeted, effective, and low side-effect treatments. But it’s important to note that patients care less about just reducing the number of monthly migraine days and more about functionality and quality of life. For example, the FDA requires studies to focus on reducing migraine days, but what really matters to patients is eliminating disability.

There’s also something called 'interictal burden,' which is the fear and worry between migraines. We've never really considered that aspect of the disease before. For some patients, this burden is can be as distressing as the migraines themselves. Migraine freedom would mean having no disability, having the proper tools to treat rare attacks, eliminating interictal burden, and ultimately living a pretty darn normal life.

That’s my biggest wish moving forward—to help patients achieve that kind of freedom and to transform what living with migraine looks like.

Additional interviews with Dr McAllister

• Neurotoxins, Biomarkers, and Migraine Advocacy: One Neurologist's Thoughts on Focus in 2025
• In Migraine Research, Placebo Effect is Increasingly Reaching Parity with Study Drug Impact: Experts Say, "What?"
• Migraine Therapeutics Research that Made News with Neurologists in 2024: Interview with Peter McAllister, MD
• American Headache Society Statement on CGRP Inhibitors is Driving Significant Change: Neurologist Peter McAllister, MD
• The Electrical Origins of Migraine May be Under the Microscope, Neurologist Peter McAllister, MD, Explains
  

Peter McAllister, MD, is associate professor of neurology at the Yale University School of Medicine, in New Haven, CT and co-founder and medical director of the New England Institute for Neurology and Headache, chief medical officer of New England Institute for Clinical Research and Ki Clinical Research, president and chief executive officer of Ki Management Services, in Stamford, CT.