Helia Hemasian Etefagh1, Shahab Shahabi Shahmiri2,3,4, Hamid Melali5, Masoud Sayadi6, Hossein Ansari7, Arvin Shahzamani8, Mitra Sadat Deyhimi9. 1. Department of Neurology, Alzahra University Hospital, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 81746-73461, Iran. 2. Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. 3. Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran. 4. Iran National Center of Excellence for Minimally Invasive Surgery Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 5. Department of Surgery, Amin Hospital, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran. 6. Department of Surgery, Al-Zahra Hospital, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran. 7. Department of Neuroscience, Kaizen Brain Center, University of California, San Diego, USA. 8. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 9. Department of Neurology, Alzahra University Hospital, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 81746-73461, Iran. mitra.deyhimi@gmail.com.
Abstract
BACKGROUND: Obesity makes migraine more prevalent and severe. Serum level of calcitonin gene-related peptide (CGRP) is associated with the severity of migraine attacks. Although the effect of weight and bariatric surgery has been studied on migraine, the role of CGRP in migraine remission after weight loss surgery needs more investigation. METHODS: Patients with severe obesity who were bariatric surgery candidates and had been diagnosed with chronic migraine were included in this study. Weight, BMI, number of days with headache in the past 3 months, and severity of headaches in 10-point Likert VAS, Migraine Disability Assessment Scale (MIDAS) and Migraine Specific Quality of life (MSQ) questionnaire scores, and serum CGRP levels were evaluated before and within 6-10 months after surgery. RESULT: Sixty patients with chronic migraine with severe obesity were included. Ninety-five percent of patients reported a significantly lower number of attacks (21 to 8, p < 0.001) and severity of headaches within 90-day (7.7 to 4.8, p < 0.001); MIDAS (64.4 to 25.5, p < 0.001) and MSQ scores (44.6 to 26.8, p < 0.001) and CGRP level (252.7 to 130.1, p < 0.001) were significantly reduced after surgery with a mean follow-up of 7.5 months. Changes in MIDAS, MSQ, and CGRP were significantly associated with weight-related variables. CONCLUSION: Bariatric surgery decreases the frequency of migraine attacks, lessens the severity of headaches, and improves the quality of life and disability as well as CGRP plasma levels, suggesting CGRP as a possible etiology in the migraine-obesity link.
BACKGROUND: Obesity makes migraine more prevalent and severe. Serum level of calcitonin gene-related peptide (CGRP) is associated with the severity of migraine attacks. Although the effect of weight and bariatric surgery has been studied on migraine, the role of CGRP in migraine remission after weight loss surgery needs more investigation. METHODS: Patients with severe obesity who were bariatric surgery candidates and had been diagnosed with chronic migraine were included in this study. Weight, BMI, number of days with headache in the past 3 months, and severity of headaches in 10-point Likert VAS, Migraine Disability Assessment Scale (MIDAS) and Migraine Specific Quality of life (MSQ) questionnaire scores, and serum CGRP levels were evaluated before and within 6-10 months after surgery. RESULT: Sixty patients with chronic migraine with severe obesity were included. Ninety-five percent of patients reported a significantly lower number of attacks (21 to 8, p < 0.001) and severity of headaches within 90-day (7.7 to 4.8, p < 0.001); MIDAS (64.4 to 25.5, p < 0.001) and MSQ scores (44.6 to 26.8, p < 0.001) and CGRP level (252.7 to 130.1, p < 0.001) were significantly reduced after surgery with a mean follow-up of 7.5 months. Changes in MIDAS, MSQ, and CGRP were significantly associated with weight-related variables. CONCLUSION: Bariatric surgery decreases the frequency of migraine attacks, lessens the severity of headaches, and improves the quality of life and disability as well as CGRP plasma levels, suggesting CGRP as a possible etiology in the migraine-obesity link.
Authors: A Verrotti; S Agostinelli; C D'Egidio; A Di Fonzo; M Carotenuto; P Parisi; M Esposito; E Tozzi; V Belcastro; A Mohn; P A Battistella Journal: Eur J Neurol Date: 2012-05-29 Impact factor: 6.089
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