Neurotoxins, Biomarkers, and Migraine Advocacy: One Neurologist's Thoughts on Focus in 2025

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Neurologist and clinical investigator Peter McAllister, MD, is eager to make progress in research on diagnosis and treatment and to hear more patient voices.

The following transcript has been edited for clarity.

Patient Care: What areas are you most eager to continue or begin work on in 2025?

McAllister: So, these new neuropeptides are really interesting. We're also wrapping up a few neurotoxin trials, and we’re hopeful that they might be the exception and show positive results. One area we’re focusing on is post-traumatic headache, which we haven’t done much work on in the past. We’re also looking at diagnosing concussion within minutes of injury—something we’re excited to launch in 2025.

Another key focus is biomarkers. There’s some limited data so far on finding a biomarker that can not only diagnose migraine specifically but also predict how a patient might respond to certain treatments. For example, some patients may respond better to CGRP drugs, while others might benefit more from PACAP-targeted therapies. It’s an area that has eluded us so far, but there’s still active research, and maybe 2025 will be the year we make significant progress.

I also see opportunities in working more closely with advocacy organizations. I didn’t realize this before, but there are around 31 different migraine and headache advocacy groups in the United States. While there are four or five larger ones, there are many smaller groups doing important work. We’ve secured some funding to bring them together in one room to discuss how we can collectively advocate for patients.

As you may know, less than half of migraine sufferers in the U.S. are seeing a clinician, getting diagnosed, and receiving proper treatment. That’s a huge gap we’re trying to address. Many of these patients face socioeconomic barriers, live in rural areas, or lack access to specialized care. We’re working to figure out how to reach the other half of these patients, so they aren’t suffering without effective treatments and access to providers.

This is something I hope we can tackle as a community in the next year or two.

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.