Gut-brain Axis and migraine headache: a comprehensive review
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
The terminology “gut-brain axis “points out a bidirectional relationship between the GI system and the central nervous system.

Researches have shown that migraine is associated with some gastrointestinal (GI) disorders such as H. pylori (HP) infection, irritable bowel syndrome (IBS) and celiac disease (CD).

Inflammatory mediators (IL-1β, IL-6, IL-8, and TNF-α), gut microbiota profile, neuropeptides and serotonin pathway, stress hormones and nutritional substances are influencing factors.

Prescribing dietary approaches with beneficial effects on gut microbiota and gut-brain axis including appropriate fiber consumption, low glycemic index diet, supplementation with vitamin D, omega-3 and probiotics as well as weight loss dietary plans could lead to improvements in migraine associated features.

The current evidence shows that the gut-brain axis may impact on migraine despite the mechanism explaining this interaction is not entirely clear. Generally, this interaction seems to be influenced by multiple factors such as inflammatory mediators (IL-1β, IL-6, IL-8, and TNF-α), gut microbiota profile, neuropeptides and serotonin pathway, stress hormones and nutritional substances. Neuropeptides including CGRP, SP, VIP, NPY are thought to have antimicrobial impact on a variety of the gut bacterial strains and thus speculated to be involved in the bidirectional relationship between the gut and the brain.

Additionally, there is comorbidity between migraine and a number of conditions including HP infection, IBS, IBD, and CD. According to the current knowledge, migraine headache in patients harboring HP might be improved following the bacteria eradication. Migraineurs with long headache history and high headache frequency have a higher chance of being diagnosed with IBS.
IBS and migraine share some similarities and can alter gut microflora composition and thereby may affect the gut-brain axis and inflammatory status. Migraine has been also associated with CD and the condition should be searched particularly in patients with migraine with occipital and parieto-occipital calcification at brain neuroimaging. In those patients, gluten-free diet can also be effective in reducing migraine frequency. Diet strategies may impact on migraine course and could represent a valuable instrument to improve migraine management.

However, no definite conclusion can be drawn because of the limited evidence on migraine management with diet. It can be hypothesized that prescribing dietary approaches with beneficial effects on gut microbiota and gut-brain axis including appropriate consumption of fiber per day, adhering to a low glycemic index diet, supplementation with vitamin D, omega-3 and probiotics as well as weight loss dietary plans (in case of obese patients) could lead to improvements in migraine associated features.

Source: https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-1078-9#Sec16
Like
Comment
Share