ECU graduate wants to solve the mysteries of migraine headaches

It might start with an aura — a scintillating scotoma of zigzag lines, opaque circles, rings of colors. You might turn or blink, but it just gets worse.

Then the pounding starts inside your head.

You’re having a migraine, and you reach for whatever remedy you’ve found most effective over the years.

Mandee Schaub knows the feeling all too well. “I’ve had 24/7 headaches since I was 12 years old,” she said. “Every day, all the time.”

Mandee Schaub stands in front of the Bioengineering and Sciences Building at the University of Texas-Dallas, where the East Carolina University grad is pursuing a doctorate in neuroscience. (Contributed photos)

A spring 2022 graduate of East Carolina University with a master’s in biomedical science and a concentration in neuroscience, Schaub plans to help people like her who suffer from the debilitating headaches. Toward that end, in August she started in the doctoral program at the University of Texas at Dallas, working in the lab of Greg Dussor — one of the nation’s few migraine research labs– and pursing a degree in cognition and neuroscience.

“I tell everyone I’m very calling driven, and I believe many people have callings for their life,” Schaub said. “Mine is to do migraine research. It’s a premier lab for migraine research in the United States, so it’s an amazing opportunity.”

Schaub is also the first migraine patient to work in Dussor’s lab. And it shows.

“She’s probably one of the most motivated students we’ve had come work here, at least in our lab,” Dussor said.

Schaub, 24, grew up in Brunswick County; her mom, Fauna, has a master’s in social work from ECU. She moved with her family to New London, near Charlotte, and graduated from Pfeiffer University in Misenheimer, studying pre-medicine. She then enrolled in graduate school at ECU, deciding research was more for her than becoming a doctor.

“I realized I could have a lot larger scale of helping people with headaches if I was helping develop therapeutics or helping find out what was causing the headaches rather than just treating patients,” she said.

“Some days it can crush you,” she added about seeking answers in the lab. “But the really cool thing is because I’m so passionate about it and because I love it so much, even the hard days are really good.”

At ECU, her mentor was Stefan Clemens, a professor of physiology at the Brody School of Medicine. She also worked closely with Kori Brewer, a professor of emergency medicine and collaborator with Clemens on pain-management research.

“They gave me a lot of freedom as long as I could give them a reason why I wanted to pursue a project,” Schaub said. “If it made sense, they were willing to let me do it. I had direct contact with them any time I wanted it. It led to these awesome brainstorming events.”

Schaub conducts electrophysiology research in the physiology lab of Stefan Clemens at the Brody School of Medicine at ECU.

Said Brewer: “She’s driven, and she’s really driven by her desire to understand what’s at the bottom of things. She gets to use what she learned here and apply it to what was driving her from the beginning.”

Working with Brewer especially inspired Schaub. “She’s so smart; she’s such a good role model in what I want for my career,” Schaub said. “I got to watch her and learn from her and set my goals for myself based on what she does.”

Schaub also worked in the ECU Office of Licensing and Commercialization, first as an innovation ambassador, serving more than 10 hours a week as a student employee; and this summer as a licensing analyst, working with faculty members to commercialize their ideas.

“I can’t say enough good things about the Office of Licensing and Commercialization,” she said. “They cold-call people and ask, ‘Do you have anything going on in your lab you could talk to us about and help you think about how those things are commercializable and how they will translate to real-world uses?’ As someone who does lab work, you don’t think as much about that other side and how to get your lab work into the hands of other people and how the process works.”

She got plenty of experience herself in how that process works. Schaub worked with Clemens and Brewer on two patents related to pain relief, including one where she is listed as a co-inventor on the provisional patent application: “Methods and compositions for preventing and treating fibrosis and improving functional recovery after injury or with aging.” The approach will be using a patented drug combination Clemens and Brewer invented that is targeting a new area: restoring neurologic function after injury.

“I helped all these professors develop their technologies and figure out if their ideas were patentable, so to have one of my own actually reach the point of a provisional patent application was overwhelmingly exciting,” she said.

Clemens added, “It could have a huge impact, even more than the pain model we have been working on in the past.”

Though it wasn’t necessarily a factor in offering her a doctoral spot, Dussor said her knowledge of translating lab findings into marketable ideas is impressive.

“That kind of experience is tremendously valuable and highly unique for a person at her stage,” he said.

She’s also been a pharmacy technician for five years and worked at a local CVS while at ECU.

“She saw people who were exposed to all these chronic pain problems and could not afford medication,” Clemens said, adding that it fueled Schaub’s desire to find ways to get medicine to patients for little or no cost.

As she seeks to understand what causes migraines and how she can translate that into therapeutics, Schaub has gotten some relief from a monoclonal antibody therapy the FDA approved in 2018.

“Prior to these medications coming on the market, there was nothing to treat my headaches, and I’ve been through every therapy, every treatment, anything they could think of to try to help me, figure out what was wrong with me and treat my headaches, and nothing would work,” Schaub said. “My sophomore year of college, they came out with new medications. Mine is called Aimovig, and it’s a monthly injection that inhibits a protein that is linked to migraine headaches. All they know is an upregulation of this protein is present in many, many people who have migraines.

“I was living at an eight (pain level) every day at that point,” she continued. “I was mostly debilitated with headaches, and I was doing a lot of grinning and bearing it. But now I’m living with like a four or five on my pain scale. Maybe once a week I’ll have a headache that’s worse. Hands and legs go numb, nausea – I’ve experienced all the things that are documented for headaches. It’s been an interesting journey, but I think it’s prepared me for what I’m about to do.”

Though she’s in Texas now, she plans to come back east to work, study or teach.

“Rural North Carolina, that’s where my heart is, so my ultimate goal is to open a nonprofit migraine treatment center somewhere in rural North Carolina,” Schaub said. “But I can definitely see myself coming back to ECU.”

Not only is Schaub the first doctoral student who has chronic migraines to work in Dussor’s lab, she’s also the first one from ECU.

“If I do a really good job, which I hope I do, hopefully, they’ll look to ECU for students,” she said.

Clemens predicted a bright future for Schaub.

“If she does as well down there as she did here, she might get a postdoc there and come back as faculty here,” Clemens said. “She definitely has the potential.”