Roberta Messina, MD, Vita-Salute San Raffaele University, Milan, Italy, discusses the use of imaging biomarkers in migraine. The interest in identifying imaging patterns that could predict a different disease course or patients’ response to treatment has increased over the last years. Several studies have already investigated imaging features that might be associated with a different disease course. Additionally, a recent study exploring patients’ response to erenumab showed higher activation of the hypothalamus in those patients. In the future, machine learning techniques in migraine will provide further information regarding disease progression and treatment response. Dr Messina believes that in the near future, imaging biomarkers will be a reality in migraine. This interview took place during the European Academy of Neurology 2021 congress.