Dr. Roberto De Icco, MD, PhD is a neurologist of the Headache Science & Neurorehabilitation Center and the coordinator of the Analysis of Movement Research Unit of the IRCCS Mondino Foundation (Pavia, Italy); he is a Researcher at the Department of Brain and Behavioral Sciences of the University of Pavia.
In this interview with Dr. Roberto De Icco, we asked him about what got him involved in migraine research, his future plans, and if he has any advice for fellow young scientists.
Even when I was a student at the University of Pavia I was fascinated by pain. Although so prevalent and disabling, chronic pain conditions were often neglected by society and physicians. The patients did not feel understood and often they did not receive the attention they deserved. When I started my internship at the IRCCS Mondino Foundation of Pavia, I got in contact with my mentors (namely Prof. Cristina Tassorelli and Prof. Giorgio Sandrini) and I was involved in a couple of projects on migraine. I was immediately impressed by the scientific quality of the headache community, and I was deeply intrigued by migraine pathophysiology.
During my residency I achieved a good expertise in clinical neurophysiology, and I saw in it a tool to explore the functional alteration of the migraine brain.
Thus, one of my main interests is to explore sensitization, habituation and brain connectivity in migraine using reliable neurophysiological tools, such as the nociceptive withdrawal reflex, the nociceptive blink reflex and high-density EEG. Along with the team of the Headache Science & Neurorehabilitation Center, we were able to provide novel data on the habituation patterns of migraine with aura and cluster headache, to describe the association between the severity of spinal central sensitization and migraine frequency, and to suggest the possible existence of specific migraine phenotypes, with different treatment response, across the migraine spectrum.
To be involved in migraine research had a huge impact on my training and career. The first, and probably the most important, point is that a I was able to get in contact with top national and international researchers. I was able to learn a lot from all of them, improving my knowledge and expertise both from scientific and clinical perspectives. My participation in migraine research also allowed me to complete two important research fellowships, one at the IRRCS Neuromed of Pozzilli (Italy), and one at the Danish Headache Center of Glostrup (Denmark). I further understood the need to deepen our knowledge on migraine to provide the best management to our patients.
Nonetheless, my involvement in migraine research gave me the opportunity to work in a third level headache center within a highly specialized neurological institute. Finally, migraine research boosted my scientific career, giving me the opportunity to complete a PhD at the University of Pavia.
There are two main factors for my continuous engagement in migraine. The first is very simple, and is that I love this topic and I’m a curious person. In the last years there were so many advances, and we now have novel drugs to manage and to study. There are so many questions yet to answer. The second point is that I truly believe that migraine, but primary headaches in general, has a huge impact on patients and society. I think we can make the difference for the patients with our work and commitment.
Regarding myself, this is probably the most difficult question to answer, because my attitude is to be focused on the present. My heart would answer that I hope I can continue doing what I like. I hope I can reach a job position that allow me to have adequate time for research.
Regarding migraine, I think the next ground-breaking step will be personalized medicine. We need solid biomarkers to select proper treatments and to refine diagnosis more and more. Each patient is different, but probably at state of art we are not sophisticated enough to understand some subtleties. I believe that a lot of scientific evidence points to in this direction and that the headache community is cohesive to achieve these goals.
Be determined and steadfast. Despite its undeniable importance and the pivotal discoveries achieved in the last years, lots of people still believe that migraine research is not a top-priory and does not need proper funding. It is very important for young researchers to think with their own head, and to travel and meet expert in the field. The national scientific societies as well as the International Headache Society are good reference points, providing a wide range of educational tools and representing important relays for all researchers around the world.