The study of migraine, particularly its pathophysiology and the optimal delivery of treatment, has been the research focus of Michael Cutrer, M.D. During his fellowship focusing on the mechanisms of migraine pathophysiology and the pharmacology of its treatment, he founded a headache subspecialty clinic from which he recruited the first human studied with blood oxygen level-dependent imaging (BOLD fMRI) during migraine with visual aura.
These and subsequent studies based on fMRI during physiologically induced and captured spontaneous migraine attacks were pivotal in establishing cortical spreading depression as the likely process underlying migraine aura in humans.
The complexity of migraine and its variable response to treatment, observed over decades of clinical practice, have convinced Dr. Cutrer that although animal models are indispensable in working out the physiological, genetic and pharmacological details, the understanding of the essential basic mechanisms underlying migraine must come from studying it in humans.
Therefore, he has spent the last decade at Mayo Clinic developing the clinomic infrastructure necessary to allow large-scale detailed genomic studies of migraine.
His long-term goal is to identify the molecular underpinnings of the migraine syndrome in order to allow more cost-effective and rational application of currently available prophylactic treatment and development of novel therapies based on the molecular cause(s) of this complex trait in each individual patient.
- Clinomics of primary headache disorders. Gathering elements of clinical information from headache patients and their treatment response data in a form that is searchable and useful as a basis for both clinical and genetic research.
- Genomics of migraine. Investigations of how genetic variation may render an individual susceptible to migraine and how prognosis and treatment response in migraine might be linked to the variants carried by each individual patient.
- Pharmacogenomics of migraine prophylactic treatment. Searching for the genetic variants that impact the effectiveness and tolerability of migraine-preventive medications.
- Functional imaging in episodic and chronic migraine. Using noninvasive techniques that generate images based on functional rather than anatomical factors. These techniques — such as functional MRI — have been very useful in investigating migraine.
Significance to patient care
Dr. Cutrer's research is focused on two basic questions that are frequently asked by patients:
- What is the basic cause of migraine?
- What treatment am I most likely to find effective and tolerate?
The underlying goals of his research are prevention and more effective treatments for this highly prevalent, pathophysiologically complex and heterogenous disorder.
- Associate Editor, Cephalalgia, 1998-present
- Headache Topic Chair, American Academy of Neurology, 2008-2012
- Scientific Advisory Board, Migraine Research Foundation, 2009-present
- Pegasus Award for Excellence in Video Media (for eight video headache case vignettes), 2007
- Telly Award for Excellence in Video Media (for six video headache case vignettes), 2011