Clinical Research Oriented Workshop (CROW) Meeting: May 20, 2021

Present:   Levi Bonnell, Nancy Gell, Ben Littenberg, Adam Sprouse-Blum, Connie van Eeghen (5)

 1.                   Warm Up: It’s May… life is good in VT… maybe not so much in less vaccinated places

2.                   Adam’s K Award application: Reviewed Research Strategy

a.       Formatting:

                                                   i.      Watch for orphans

b.       Significance:

                                                   i.      Impact on people – how burdensome is migraine?

                                                 ii.      What is the additional burden of left sided headache?

                                               iii.      If bilateral is important, where does it belong in the Significance section, and why? Add to second paragraph. “Is bilateral migraine different from L/R or is bilateral the combination of L/R?”

c.       Language

                                                   i.      “I” or “We” – whatever you use, be consistent.  OK to be 1^st person singular in a K award.

d.       Analyses

                                                   i.      What to do about adjusting for multiple hypotheses? TBD

e.       Potential problems:

                                                   i.      Not generalizable to rare forms of migraine or other headache syndromes

                                                 ii.      Convenience sample: patients close to the Med Center and can come in without notice; may not be generalizable to other groups

                                               iii.      Small sample size

                                               iv.      Inadequate sample size is a threat to the study, however… (bridge to existing language in draft)

                                                 v.      Patients lost in prior study: 1 out of three not able to conduct study; able to retain when presented with their next attack

1.       Unable to tolerate scan – all 10 finished the migraine scan but, for the non-migraine scan, 1 was retriggered during the scan due to flashing lights (reaction to the protocol) – later returned to repeat scan without flashing lights; we will use such tactics going forward

f.        Other:

                                                   i.      Consider a conceptual model that drives migraine responsiveness in different hemispheres: are there structural differences in the brain that are reflected in migraine laterality, such as:

1.       Blood flow

2.       Neuronal activity

3.       Cerebral vascular reactivity

4.       Cognition based on what lights up

                                                 ii.      Or, are there intrinsic brain structures that influence laterality, or there is something else that affects laterality, are the symptoms primary to migraine?

                                               iii.      Include a list of outcomes

1.       Identify predictor: laterality of migraine

2.       Identify outcomes in relationship to predictor

3.                   Next week:  TBA