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Brewerton TD, Dennis K, Wiss DA. Dismantling the myth of "all foods fit" in eating disorder treatment. J Eat Disord 2024; 12:60. [PMID: 38760858 PMCID: PMC11102136 DOI: 10.1186/s40337-024-01017-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
We call for a reevaluation of the long-standing dogmatic nutritional principle that "all foods fit" for all cases of eating disorders (EDs) and its corollary, "there are no bad foods" (for anyone ever) during ED treatment. Based on accumulated scientific research, we challenge these ideologies as outdated, confusing, and potentially harmful to many patients. We review the evidence that indicates the folly of these assumptions and show there are a variety of exceptions to these rules, including (1) food allergies, sensitivities, and intolerances, (2) religious and spiritual preferences or doctrines, and (3) the ubiquitous emergence and widespread availability of ultra-processed foods leading to the potential development of addiction-like eating and a higher prevalence of various medical and psychiatric comorbidities, as well as higher mortality. This evidence supports a nutritional psychiatry approach that should be integrated into (rather than dissociated from) ED treatment research and practice.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Kim Dennis
- SunCloud Health, Chicago, IL, USA
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago, IL, USA
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Baglioni V, Bozza F, Beatrice A, Cameli N, Colacino Cinnante EM, Lentini G, Faedda N, Natalucci G, Guidetti V. Non-Pharmacological Treatments in Paediatric Migraine. J Clin Med 2024; 13:1278. [PMID: 38592096 PMCID: PMC10932388 DOI: 10.3390/jcm13051278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
Psychological, social, and biological aspects contribute synergistically to the maintenance and chronicity of pain in primary headaches. An integrated intervention seems to be the most appropriate in the management of these conditions, taking advantage not only of pharmacological strategies, but also of different approaches according to the global assessment and patient necessities. In this perspective, non-pharmacological treatments are becoming increasingly used to overcome these issues also in paediatric migraine treatment. Particularly, nutraceuticals, non-invasive neuromodulation, and behavioural approaches are well tolerated and of potential interest. This paper aims to present the main approaches reported in the literature in the management of migraine in children and adolescents presenting an up-to-date review of the current literature. We therefore performed a narrative presentation for each of these three categories: nutraceuticals (riboflavin; magnesium; melatonin; vitamin D; coenzyme Q10; and polyunsaturated fatty acid); non-invasive neuromodulation (trigeminal nerve stimulator; non-invasive vagal nerve stimulation; transcranial magnetic stimulation; and remote electrical neuromodulation), and behavioural therapies (biofeedback; cognitive behavioural therapy; and mindfulness-based therapy). These approaches are increasingly seen as a valid treatment option in primary headache management also in paediatrics, avoiding medication overuse and drug treatment contraindications.
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Affiliation(s)
- Valentina Baglioni
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy; (F.B.); (A.B.); (N.C.); (E.M.C.C.); (G.L.); (N.F.); (G.N.); (V.G.)
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Abstract
PURPOSE OF REVIEW The purpose of this review is to present the latest research findings about diet and migraine, what can be used in the clinic now, and what needs further investigation. RECENT FINDINGS Recent findings highlight that dietary triggers exist for migraine, for example, coffee and alcohol, according to a new systematic review. Elimination diets must be personalized to delineate a balanced diet with acceptable quality and pattern. A piece of average-quality evidence shows that the ketogenic diet (KD) and the Dietary Approaches to Stop Hypertension (DASH) are effective in reducing the frequency, duration, and severity of migraine headaches in adult patients. The gut microbiome is altered in patients with migraine, and further research will identify the benefits of pre and probiotic use for migraine. Advanced digital technology in continuous monitoring can provide educational content based on patients' needs, help patients adhere to dietary plans, and strengthen personalized care. The complex interaction of lifestyle factors, the influence of age and sex, and patients' needs in various life phases are essential in formulating dietary plans. SUMMARY The diet-migraine interaction is a dynamic bidirectional phenomenon that requires careful monitoring, review, and justification of dietary choices to yield the optimal outcome while minimizing potential risks.
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Affiliation(s)
- Parisa Gazerani
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University
- Centre for Intelligent Musculoskeletal Health (CIM), Faculty of Health Sciences, Oslo Metropolitan University, Norway
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, Gistrup, Denmark
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Quispe-Vicuña C, Soriano-Moreno DR, De-Los-Rios-Pinto A, Díaz-Ledesma LA, Fernandez-Guzman D, Pacheco-Barrios K, Alva-Diaz C. Association between weight status and migraine in the paediatric population: a systematic review and meta-analysis. Front Neurol 2023; 14:1225935. [PMID: 38033769 PMCID: PMC10682819 DOI: 10.3389/fneur.2023.1225935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction An association between weight status and migraine has been previously reported; however, this relationship has only been studied in adults, not in the paediatric population. Objective To evaluate the association between weight status and migraine in the paediatric population. Methods We searched PubMed/Medline, Scopus, Web of Science, Ovid Medline, and Embase using a cut-off date of May 2023. We included observational studies that evaluated the association between weight status (underweight, overweight, obese, and excess weight) and migraine in the paediatric population (children and adolescents). Normal weight was the comparator. The outcome was migraine (all types, episodic and chronic). We performed meta-analyses using a random-effects model to estimate the pooled effects for each outcome. Sensitivity analysis was performed based on study design and risk of bias (using the Newcastle-Ottawa Scale). Certainty of evidence was assessed using the GRADE approach. Results Eight studies (6 cross-sectional, 1 case-control and 1 cohort) covering 16,556 patients were included. The overall certainty of evidence was very low for the association between overweight, obesity, and excess weight with migraine. In the sensitivity analysis, meta-analyses of studies with a low risk of bias found that the overweight population probably had an increased odds of migraine (OR: 1.70; 95% CI: 1.14 to 2.53; I2 = 32.3%, p = 0.224) and that excess weight may increase the odds of migraine (OR: 1.58; 95% CI: 1.06 to 2.35; I2 = 83.7%, p = 0.002). Additionally, cohort and case-control studies found that obesity probably increases the odds of migraine. No studies analysed the association between underweight and migraine. Conclusion The associations between overweight, obesity, excess weight and migraine were uncertain, but studies with better methodological quality reported increased odds. Future longitudinal studies with proper confounding control are needed to disentangle their causal relationship. Systematic review registration PROSPERO, identifier CRD42021271533.
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Affiliation(s)
- Carlos Quispe-Vicuña
- Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Red de Eficacia Clínica y Sanitaria (REDECS), Lima, Peru
| | - David R. Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Facultad de Medicina, Universidad Peruana Unión, Lima, Peru
| | - Abraham De-Los-Rios-Pinto
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | - Luz A. Díaz-Ledesma
- Veritas Sociedad Científica de Estudiantes de Medicina, Universidad de San Martín de Porres, Chiclayo, Peru
| | | | - Kevin Pacheco-Barrios
- Unidad de Investigación para la Generación y Síntesis de Evidencia en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- Neuromodulation Center y Center for Clinical Research Learning, Spaulding Rehabilitation Hospital y Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Departamento de Epidemiología, Escuela de Salud Pública T. H. Chan de Harvard, MA, United States
| | - Carlos Alva-Diaz
- Red de Eficacia Clínica y Sanitaria (REDECS), Lima, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
- Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru
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Neri LDCL, Ferraris C, Catalano G, Guglielmetti M, Pasca L, Pezzotti E, Carpani A, Tagliabue A. Ketosis and migraine: a systematic review of the literature and meta-analysis. Front Nutr 2023; 10:1204700. [PMID: 37377485 PMCID: PMC10292926 DOI: 10.3389/fnut.2023.1204700] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Headaches are a prevalent disorder worldwide, and there is compelling evidence that certain dietary interventions could provide relief from attacks. One promising approach is ketogenic therapy, which replaces the brain's glucose fuel source with ketone bodies, potentially reducing the frequency or severity of headaches. Aim This study aims to conduct a systematic review of the scientific literature on the impact of ketosis on migraine, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Results After a careful selection process and bias evaluation, 10 articles were included in the review, primarily from Italy. The bias assessment indicated that 50% of the selected articles had a low risk of bias in all domains, with the randomization process being the most problematic domain. Unfortunately, the evaluation of ketosis was inconsistent between articles, with some assessing ketonuria, some assessing ketonemia, and some not assessing ketosis levels at all. Therefore, no association could be made between the level of ketosis and the prevention or reduction of migraine attacks. The ketogenic therapies tested in migraine treatments included the very low-calorie ketogenic diet (VLCKD, n = 4), modified Atkins diet (MAD, n = 3), classic ketogenic diet (cKDT, n = 2), and the administration of an exogenous source of beta-hydroxybutyrate (BHB). The meta-analysis, despite reporting high heterogeneity, found that all interventions had an overall significant effect (Z = 9.07, p < 0.00001; subgroup differences, Chi2 = 9.19, dif = 3, p = 0.03; I2, 67.4%), regardless of the type of endogenous or exogenous induction of ketosis. Conclusion The initial findings of this study suggest that metabolic ketogenic therapy may provide some benefit in treating migraines and encourage further studies, especially randomized clinical trials with appropriate and standardized methodologies. The review strongly recommends the use of the adequate measurement of ketone levels during ketogenic therapy to monitor adherence to the treatment and improve knowledge of the relationship between ketone bodies and efficacy. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022330626.
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Affiliation(s)
- Lenycia de Cassya Lopes Neri
- Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil
| | - Cinzia Ferraris
- Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Guido Catalano
- Department of Child Neurology and Psychiatry, Istituto di Ricerca e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Monica Guglielmetti
- Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Ludovica Pasca
- Department of Child Neurology and Psychiatry, Istituto di Ricerca e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elena Pezzotti
- Department of Child Neurology and Psychiatry, Istituto di Ricerca e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | - Adriana Carpani
- Department of Child Neurology and Psychiatry, Istituto di Ricerca e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | - Anna Tagliabue
- Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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Ferretti A, Gatto M, Velardi M, Di Nardo G, Foiadelli T, Terrin G, Cecili M, Raucci U, Valeriani M, Parisi P. Migraine, Allergy, and Histamine: Is There a Link? J Clin Med 2023; 12:jcm12103566. [PMID: 37240671 DOI: 10.3390/jcm12103566] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The relationship between migraines and allergies is controversial. Though they are epidemiologically linked, the underlying pathophysiological connection between them remains unclear. Migraines and allergic disorders have various underlying genetic and biological causes. As per the literature, these conditions are epidemiologically linked, and some common pathophysiological pathways have been hypothesized. The histaminergic system may be the clue to understanding the correlation among these diseases. As a neurotransmitter in the central nervous system with a vasodilatory effect, histamine has a well-documented influence on the allergic response and could be involved in the pathophysiology of migraines. Histamine may influence hypothalamic activity, which may play a major role in migraines or may simply influence their severity. In both cases, antihistamine drugs could prove useful. This review examines whether the histaminergic system, particularly H3 and H4 receptors, may provide a mechanistic link between the pathophysiology of migraines and allergic disorders, two common and debilitating conditions. Identifying their connection could help identify novel therapeutic strategies.
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Affiliation(s)
- Alessandro Ferretti
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Mattia Gatto
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Margherita Velardi
- General and Emergency Department, Bambino Gesù Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Giovanni Di Nardo
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Thomas Foiadelli
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Gianluca Terrin
- Department of Mother and Child, Gynecological and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Manuela Cecili
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Umberto Raucci
- General and Emergency Department, Bambino Gesù Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Massimiliano Valeriani
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Pasquale Parisi
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
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Loh NR, Whitehouse WP, Howells R. What is new in migraine management in children and young people? Arch Dis Child 2022; 107:1067-1072. [PMID: 35190383 DOI: 10.1136/archdischild-2021-322373] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/29/2022] [Indexed: 12/14/2022]
Abstract
For this narrative review, we found recent publications on the use and effectiveness of old therapies including nutraceuticals, such as riboflavin, vitamin D, magnesium, melatonin and talking therapies. Recent large trials of established conventional pharmaceuticals such as propranolol, pizotifen, topiramate and amitriptyline for childhood migraine have failed, but the use of a quasi-placebo in future trials could help. We reviewed the evidence for angiotensin antagonists including candesartan in adults, but found a lack of evidence for their use in children. There have been new developments in pharmaceuticals recently, including a more selective 5-HT1F agonist, lasmiditan, an effective acute treatment with no vasoconstrictor activity in adults, currently being tested in children. Also, a number of new calcitonin gene-related peptide (CGRP) antibodies and antagonists, with proven efficacy in acute treatment and/or prevention of migraine in adults, are undergoing trials in children. Peripheral nerve blocks and botulinum toxin are gaining popularity in adult practice, but we really need more good quality evidence for their effectiveness in children. Finally, electroceuticals, that is, therapeutic electric devices, are now marketed for acute and or preventative treatment, including an external trigeminal nerve stimulator (e-TNS), a non-invasive vagal nerve stimulator (nVNS), a single-pulse transcranial magnetic stimulator (sTMS) and a remote electrical neuromodulation device (REN). At the moment, evidence for their effectiveness in children is still lacking. So, there has been much progress, but mostly for adults. We are in urgent need of more migraine trials in children.
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Affiliation(s)
- Ne Ron Loh
- Paediatrics, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.,Paediatrics, Noah's Ark Children's Hospital for Wales, Cardiff, UK
| | | | - Rachel Howells
- Royal Devon and Exeter NHS Trust, Children & Young People, Exeter, UK
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Brewerton TD, Perlman MM, Gavidia I, Suro G, Jahraus J. Headache, eating disorders, PTSD, and comorbidity: implications for assessment and treatment. Eat Weight Disord 2022; 27:2693-2700. [PMID: 35604548 DOI: 10.1007/s40519-022-01414-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/30/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Severe headaches (HAs) have been associated with eating disorders (ED) as well as with trauma, posttraumatic stress disorder (PTSD), major depression and anxiety. However, data addressing all of these factors in the same subjects are limited. METHODS In a large sample of patients (n = 1461, 93% female) admitted to residential treatment (RT) for an ED, we assessed within 48-72 h of admission subjective reports of frequent HAs and their associations with severity of ED, PTSD, major depressive and state-trait anxiety symptoms, as well as quality of life measures. HA ratings were significantly correlated to the number of lifetime trauma types as well as to symptoms of PTSD, major depression, and state-trait anxiety. RESULTS Results indicated that 39% of patients endorsed that frequent HAs occurred "often" or "always" (HA+) in association with their eating or weight issues. This HA-positive (HA+) group had statistically significant higher numbers of lifetime trauma types, higher scores on measures of ED, PTSD, major depressive, and state-trait anxiety symptoms, and worse quality of life measures (p ≤ 0.001) in comparison to the HA-negative (HA-) group, who endorsed that frequent HAs occurred "never," "rarely," or "sometimes" in association with their eating or weight issues. The HA + group also had a significantly higher rate of a provisional PTSD diagnosis (64%) than the HA- group (35%) (p ≤ .001). Following comprehensive RT, HA frequency significantly improved (p ≤ .001). CONCLUSION These findings have important implications for the assessment and treatment of HAs in the context of ED, PTSD and related psychiatric comorbidities, especially at higher levels of care. In addition, the importance of identifying traumatic histories and treating comorbid PTSD and related psychopathology in individuals presenting with severe HAs is emphasized. LEVEL OF EVIDENCE III Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. .,Timothy D. Brewerton, MD, LLC, Mt. Pleasant, SC, USA. .,Monte Nido and Affiliates, Miami, FL, USA.
| | - Molly M Perlman
- Monte Nido and Affiliates, Miami, FL, USA.,Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA
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Hatem G, Mosleh R, Goossens M, Khachman D, Al-Hajje A, Awada S. Prevalence and risk factors of migraine headache among university students: A cross-sectional study in Lebanon. HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2022.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background
Migraine constitutes a major public health concern since it negatively affects both the quality of life and the productivity of patients. Migraine among students can cause impaired academic performance and limit their daily activities.
Objective
This study aims to assess the prevalence of migraine among university students using the ID Migraine screening tool and to evaluate risk factors associated with migraine.
Methods
A cross-sectional study was performed over a period of six months targeting 1144 university students recruited from the different faculties.
Results
Migraine was suggested in 35.8% of subjects based on ID-Migraine. Migraine prevalence was significantly higher among women (42% versus 23.3% of men). After adjusting for covariates, women, daily coffee consumption, having unorganized meals, eating fast food and fasting were the main predictors of migraine. Almost 41% of migraine students had a family history of migraine and only 26.7% sought medical help. Interestingly, most of the migraine students (84.8%) took headache medications without referring them to their doctor.
Conclusion
Recognizing headache risk factors among migraine students and adopting lifestyle changes accordingly can be an effective strategy to prevent the chronification of the attacks, decrease headache frequency and improve patients’ quality of life.
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A Digital Therapeutic Allowing a Personalized Low-Glycemic Nutrition for the Prophylaxis of Migraine: Real World Data from Two Prospective Studies. Nutrients 2022; 14:nu14142927. [PMID: 35889884 PMCID: PMC9315551 DOI: 10.3390/nu14142927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022] Open
Abstract
Migraine is a headache disorder associated with a high socioeconomic burden. The digital therapeutic sinCephalea provides an individualized low-glycemic diet based on continuous glucose measurement and is intended to provide a non-pharmacological migraine prophylaxis. We performed two prospective studies with migraine patients who used sinCephalea over a period of 16 weeks. The patients used a headache diary and recorded their migraine-related daily life impairments using the assessment tools HIT-6 and MIDAS for a pre versus post comparison. In addition, continuous glucose data of patients were compared to healthy controls. In both studies, patients reported a reduction of headache and migraine days as well as reductions in HIT-6 and MIDAS scores. More specifically, migraine days decreased by 2.40 days (95% CI [−3.37; −1.42]), HIT-6 improved by 3.17 points (95% CI [−4.63; −1.70]) and MIDAS by 13.45 points (95% CI [−22.01; −4.89]). Glucose data suggest that migraine patients have slightly increased mean glucose values compared to healthy controls, but drop into a glucose range that is below one’s individual standard range before a migraine attack. In conclusion, sinCephalea is a non-pharmacological, digital migraine prophylaxis that induces a therapeutic effect within the range of pharmacological interventions.
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Papetti L, Tarantino S, Ursitti F, Moavero R, Proietti MC, Sforza G, Monte G, Ferilli MAN, Balestri M, Vigevano F, Valeriani M. From the New Diagnostic Criteria to COVID-19 Pandemic Passing Through the Placebo Effect. What Have We Learned in the Management of Pediatric Migrane Over the Past 5 Years? Front Neurol 2022; 13:935803. [PMID: 35911893 PMCID: PMC9326104 DOI: 10.3389/fneur.2022.935803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
In 2018, the Food and Drug Administration (FDA) approval of anti-calcitonin gene-related peptide (CGRP) therapies for the treatment of migraine represented a milestone for the management of the disease in adults. On the contrary, the novelties in the field of pediatric migraine are inserted in a different scenario and still concern: (1) diagnostic criteria of the international classification of headache disorders-3 (ICHD-3) that show numerous limits of applicability in the developmental age; (2) the release of the results of the Childhood and Adolescent Migraine Prevention (CHAMP) study that raised doubts about the usefulness of traditional drugs for the treatment of pediatric migraine; (3) the Coronavirus disease 2019 (COVID-19) pandemic has put the spotlight on the importance of managing the psychological factors associated with the disease. In this mini review we discuss the most relevant news in pediatric migraine over the last 5 years.
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Affiliation(s)
- Laura Papetti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Samuela Tarantino
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Fabiana Ursitti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Romina Moavero
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Martina Checchi Proietti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Giorgia Sforza
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Gabriele Monte
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Michela Ada Noris Ferilli
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Martina Balestri
- Child Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Federico Vigevano
- Child Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Massimiliano Valeriani
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
- *Correspondence: Massimiliano Valeriani
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Fila M, Chojnacki C, Chojnacki J, Blasiak J. Nutrients to Improve Mitochondrial Function to Reduce Brain Energy Deficit and Oxidative Stress in Migraine. Nutrients 2021; 13:nu13124433. [PMID: 34959985 PMCID: PMC8707228 DOI: 10.3390/nu13124433] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022] Open
Abstract
The mechanisms of migraine pathogenesis are not completely clear, but 31P-nuclear magnetic resonance studies revealed brain energy deficit in migraineurs. As glycolysis is the main process of energy production in the brain, mitochondria may play an important role in migraine pathogenesis. Nutrition is an important aspect of migraine pathogenesis, as many migraineurs report food-related products as migraine triggers. Apart from approved anti-migraine drugs, many vitamins and supplements are considered in migraine prevention and therapy, but without strong supportive evidence. In this review, we summarize and update information about nutrients that may be important for mitochondrial functions, energy production, oxidative stress, and that are related to migraine. Additionally, we present a brief overview of caffeine and alcohol, as they are often reported to have ambiguous effects in migraineurs. The nutrients that can be considered to supplement the diet to prevent and/or ameliorate migraine are riboflavin, thiamine, magnesium ions, niacin, carnitine, coenzyme Q10, melatonin, lipoic acid, pyridoxine, folate, and cobalamin. They can supplement a normal, healthy diet, which should be adjusted to individual needs determined mainly by the physiological constitution of an organism. The intake of caffeine and alcohol should be fine-tuned to the history of their use, as withdrawal of these agents in regular users may become a migraine trigger.
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Affiliation(s)
- Michal Fila
- Department of Developmental Neurology and Epileptology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland;
| | - Cezary Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (C.C.), (J.C.)
| | - Jan Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (C.C.), (J.C.)
| | - Janusz Blasiak
- Department of Molecular Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236 Lodz, Poland
- Correspondence:
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