Spinoza prize for 'migraine professor' Michel Ferrari
Neurologist Professor Michel Ferrari has been awarded the Spinoza prize. 'In biomedical research you can only make breakthroughs at the borders between sciences,' according to Spinoza, doctor and scientist. 'This prize is proof that co-operation works.' Together with clinical and fundamental researchers from different fields he is little by little unravelling the puzzle that is migraine.'
2.5 million for research
The Spinoza prize, awarded by NWO, is the most prestigious scientific prize in the Netherlands. Ferrari will have 2.5 million euro to devote to research into migraine, a condition that affects 12 per cent of the population, and which he is deciphering little by little, together with an interdisciplinary team of clinical and fundamental researchers. The eventual aim is to produce a so-called prophylactic medication that will prevent attacks of migraine.
‘This award is proof that co-operation works. You can only make breakthroughs at the borders between sciences. Biomedical scientific research is working together,' says Ferrari. 'This is why is is so important to speak one another's language and to respect and understand one another's work. Only then can you bridge the cultural differences between doctors and fundamental researchers - between doctors and lab staff, between clinical specialists and geneticists. These cultural differences are considerable - even today - and they are the reason why the majority of partnerships break down.'
Thinking out of the box
Even today? 'Yes, even today. I still see too many clinical specialists who believe genetic analysis is a bit of a gimmick. Or geneticists who believe that human matter is the same as matter from rats. They have no idea how difficult it is to acquire, and have never actually seen a patient.' He regards the prize not only as a prize for himself, but - 'it may sound as if I'm saying this out of a feeling of obligation' - but for the whole research group, for the collegues in his department, for the LUMC that allowed him the freedom to pursue his studies, to think out of the box.
Not a condition of hysterical women
Migraine is a condition that is often misjudged, says Ferrari: ‘It was for a long time treated as an illness of hysterical women, who suffered migraine attacks as a result of stress. But migraine has nothing to do with stress. The WHO recently placed migraine among the top, most disabling illnesses. Migraine is very common, and is the most expensive brain disease for society, because of the effect of major and unpredictable absenteeism that it causes.'
Migraine is experienced in attacks that include very painful headaches, nausea, vomiting and sensitivity to light, noise and other external stimuli. Ferrari: ‘Everyone has at least one or two attacks in their lifetime. But you are only termed as suffering from chronic migraine if you suffer frequent attacks.' One-third of patients also suffer some kind of loss of brain function, often the loss of part of one's vision, but this can also manifest itself as paralysis on one side. And there is also a very rare sub-form of migraine that can be fatal, Ferrari explains. 'In the case of these people, a light knock on the head can lead to serious swelling of the brain. Recent research carried out together with the radiology department shows that repeated migraine attacks can also cause brain damage.'
Migraine is often not properly recognised. 'Of course, we don't see the patient when he or she is in the middle of an attack. And migraine is often experienced together with other illnesses: depression, epilepsy and heart attacks and strokes. What's interesting is that one is not the cause of the other. For example, you don't get depression just because you have so many headaches. It works both ways. Anyone who has migraine has an increased likelihood of depression, and vice versa. That does indicate a common underlying cause.'
Combination of genes
Ferrari's research group was the first to identify a gene for a type of migraine, a rare type that causes long-term one-sided paralysis. That was in 1996. Later they discovered a further three genes. 'Much of our research focuses on the genetic and biochemical basis for the low stimulus threshhold typical of migraine. There are many genes that play a role here. Only in very rare types of migraine, such as the type that is accompanied by swelling of the brain, is there just a single gene involved.'
Dream: a specific medicine
‘Our dream is to be able to treat patients with a prophylactic medicine that will prevent migraine attacks. To date there are only aspecific medicines developed for some other condition but that has also been shown to have an effect on migraine. And an aspecific medicine means by definition: a lot of side-effects. We are looking for a specific medicine without any side-effects. But to achieve this not only do we need to know about the complicated combination of genes, we also need to know the biochemical route from gene to attack in the minutest detail.
What will the 2.5 million euro Spinoza prize be used for? 'I think - and I've only just heard the news myself - that we will set up a new research line into the role of glia cells in migraine. These are the cells in which the nerve tissue, the neurons, is packed. Previously, it was thought that these glia cells were only a kind of support tissue. But that is not the case, they apparently have an important regulatory role, and are able to influence the function of the nerve cells. There are indications that they also play a role in migraine. This is something we want to research further.'
Michel Ferrari graduated in medicine in Leiden in 1980, and obtained his PhD here with distinction in 1992. In 2002 he was appointed Professor in Neurology in Leiden. He works within the University research profile area Brain Function and Dysfunction over the Lifespan. Ferrari has many important prizes and subsidies to his name, including a Vici subsidy from NWO in 2004. He has also held a number of prestigious management positions in national and international scientific organisations. He was chairman of the International Headache Society and is currently chair of the Netherlands Headache Association and the Leiden Centre for Translational Neuroscience. Ferrari has some 350 publications and almost 10,000 citations to his name. He attracts many highly talented young researchers from within the Netherlands and abroad and also involves talented school pupils in his research.
Ferrari is known worldwide as an opinion leader in the field of neurology and is a much requested speaker whose aim is to rectify misunderstandings and prejudices about migraine. Together with a colleague he write the book Alles over hoofdpijn en aangezichtspijn (All you need to know about headache and facial pain), a best-seller among headache sufferers. He is Leiden's twelfth Spinoza winner. The prize was awarded for the first time in 1995. With 22% of all Spinoza prizes awarded to date, Leiden University is the front-runner. Further information about the prize can be found on Spinoza Prize.