Clinical Focus

  • Neurology
  • Headache Medicine

Academic Appointments

Administrative Appointments

  • President, Headache Cooperative of the Pacific (2012 - Present)
  • Director,Stanford Headache Program, Stanford University School of Medicine (2011 - Present)
  • Chair, Refractory Headache Special Interest Section, American Headache Society, American Headache Society (2012 - Present)
  • Vice President, Headache Cooperative of the Pacific (2007 - 2012)
  • Program Director, Headache Cooperative of the Pacific (2007 - 2011)

Honors & Awards

  • Fellow, American Academy of Neurology (2006)
  • Fellow, American Academy of Neurology (2010)
  • Chief Resident, LAC/USC, Los Angeles, California (1989)
  • Woodrow Wilson Scholar, Clark University, Worcester, Massachusetts (1972)
  • Magna Cum Laude, Clark University, Worcester, Massachusetts (1972)

Boards, Advisory Committees, Professional Organizations

  • Member, Board of Directors, Alliance for Headache Disorders Advocacy (2009 - Present)
  • Member, Board of Directors, Headache Cooperative of the Pacific (2007 - Present)
  • Member, Advisory Committee, NCAA Select committee on headache in collegiate atheletes (2013 - Present)
  • Member,, American Headache Society (1995 - Present)
  • Member, American Academy of Neurology (1990 - Present)
  • Member, International Headache Society (2010 - Present)

Professional Education

  • Residency:LAC and USC Medical Center (1990) CA
  • Internship:LAC and USC Medical Center (1987) CA
  • Medical Education:Keck School of Medicine University of Southern CA (1986) CA
  • Board Certification: Neurology, American Board of Psychiatry and Neurology (1994)

Research & Scholarship

Current Research and Scholarly Interests

Current interest focus on patient education technology and patient/physician communication with a particular emphasis on tools which increase encounter efficiency and improve outcomes. Present projects include development of on-line tools to generate detailed patient histories and delineation of diagnostic impressions based on established criteria, generation of criteria for standardized credentialing of educators in headache, including training, testing and certification.


2013-14 Courses

Postdoctoral Advisees


Journal Articles

  • Does exercise make migraines worse and tension type headaches better? Current pain and headache reports Hindiyeh, N. A., Krusz, J. C., Cowan, R. P. 2013; 17 (12): 380-?


    Many non-pharmacological treatments have been implicated in the treatment of primary headache, with exercise being a common recommendation. In this review we first provide an overview of the relationship between exercise and primary headaches. We then review the physiology of pain modulation, with focus on the endogenous opioids, endocannabinoids, and neuropeptides calcitonin gene-related peptide (CGRP) and brain-derived neurotrophic factor (BDNF), and their associations with primary headache and exercise. Finally, we summarize current literature evaluating effects of exercise on primary headache in an effort to understand the benefits and disadvantages of exercise in primary headaches.

    View details for DOI 10.1007/s11916-013-0380-5

    View details for PubMedID 24234818

  • Phospholipase C activity increases in cerebrospinal fluid from migraineurs in proportion to the number of comorbid conditions: a case-control study JOURNAL OF HEADACHE AND PAIN Fonteh, A. N., Pogoda, J. M., Chung, R., Cowan, R. P., Harrington, M. G. 2013; 14


    Migraineurs are more often afflicted by comorbid conditions than those without primary headache disorders, though the linking pathophysiological mechanism(s) is not known. We previously reported that phosphatidylcholine-specific phospholipase C (PC-PLC) activity in cerebrospinal fluid (CSF) increased during migraine compared to the same individual's well state. Here, we examined whether PC-PLC activity from a larger group of well-state migraineurs is related to the number of their migraine comorbidities.In a case-control study, migraineurs were diagnosed using International Headache Society criteria, and controls had no primary headache disorder or family history of migraine. Medication use, migraine frequency, and physician-diagnosed comorbidities were recorded for all participants. Lumbar CSF was collected between the hours of 1 and 5 pm, examined immediately for cells and total protein, and stored at -80C. PC-PLC activity in thawed CSF was measured using a fluorometric enzyme assay. Multivariable logistic regression was used to evaluate age, gender, medication use, migraine frequency, personality scores, and comorbidities as potential predictors of PC-PLC activity in CSF.A total of 18 migraineurs-without-aura and 17 controls participated. In a multivariable analysis, only the number of comorbidities was related to PC-PLC activity in CSF, and only in migraineurs [parameter estimate (standard error) = 1.77, p = 0.009].PC-PLC activity in CSF increases with increasing number of comorbidities in migraine-without-aura. These data support involvement of a common lipid signaling pathway in migraine and in the comorbid conditions.

    View details for DOI 10.1186/1129-2377-14-60

    View details for Web of Science ID 000321647800001

    View details for PubMedID 23826990

  • Cerebrospinal fluid phosopholipase C activity increases in migraine. Cephalalgia Alfred N Fonteh, Rainbow Chung, Tara L Sharma, R Danielle Fisher, Janice M Pogoda, Robert Cowan, Michael G Harrington 2011; 31 (4): 456-462
  • Capillary Endothelial Na+, K+, ATPase Transporter Homeostasis and a New Theory for Migraine Pathophysiology. Headache Harrington, M.G., Fonteh, A.N., Arakaki, X., Cowan, R.P., Ecke, L.E., Foster, H., Huhmer, A.F., & Biringer, R. 2010; 50 (3): 459-78
  • The morphology and biochemistry of nanostructures provide evidence for synthesis and signaling functions in human cerebrospinal fluid. Cerebrospinal Fluid Res. Harrington MG, Fonteh AN, Oborina E, Liao P, Cowan RP, McComb G, Chavez JN, Rush J, Biringer RG, Huhmer AF. 2009: 6:10
  • Prostaglandin D Synthase Isoforms from Cerebrospinal Fluid Vary with Brain Physiology. Disease Markers Harrinton MG, Fonteh AN, Biringer RG, Huhmer AF, Cowan RP. 2006; 22 (1-2): 73-81
  • Cerebrospinal Fluid Sodium Increases in Migraine Headache Harrington MG, Fonteh AN, Cowan RP, Perrine K, Pogoda JM, Biringer, RG, Huhmer AFR. 2006; 46 (7): 1128-1135

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