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Published on: January 27, 2019
Gut microbiota, probiotics, and migraine: a clinical review and meta-analysis
Olga Grodzka1,2, Izabela Domitrz1
1Department of Neurology, Faculty of Medicine and Dentistry, Medical University of Warsaw, 01-809 Warsaw, Poland.
Abstract:
Migraine is a primary headache disorder affecting about 14% of the global population. The knowledge about migraine pathophysiology is increasing constantly; however, there are still many unknowns and uncertainties. Intestinal microbiota builds the gut environment together with metabolites and the immune system. Its connections with disorders outside the digestive system have been described, mainly neuropsychiatric diseases, due to the existence of the microbiota-gut-brain axis. Therefore, it is suggested that migraine is also correlated with changes in the microbiome. The review aimed to summarize the available literature related to the topic. We performed an electronic article search through the Embase Database and PubMed Database, and included 14 articles after analysis under the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. Subsequently, a meta-analysis of randomized controlled clinical trials summarizing probiotics' effect on migraine prevention was conducted based on the same guidelines and resulted in including 2 adequate trials. Microbiome alterations have been observed in migraine patients with an influence on clinical presentation. Preclinical studies suggested a direct connection between migraine and microbiome changes. The meta-analysis has shown the influence of probiotics on migraine frequency (p = 0.003; Hedges' g = 1.22; standard error (SE) = 0.41), and no impact on migraine severity (p = 0.069; Hedges' g = 1.10; SE = 0.61) and attacks' duration (p = 0.149; Hedges' g = 0.18; SE = 0.15). However, the former was close to the statistical significance. The following work demonstrates a correlation between migraine and microbiome, which has a putative positive impact on migraine management. Moreover, probiotic supplementation can alleviate migraine symptoms. However, the main limitation is the limited number of studies, together with high heterogeneity and limited methodological consistency in the meta-analysis.
Insights
Migraine may be linked to gut microbiome changes. Probiotic supplements show potential in reducing migraine frequency, though more research is needed to confirm effects on severity and duration.
Area of Science:
- Neurology
- Microbiology
- Gastroenterology
Background:
- Migraine is a prevalent neurological disorder with complex pathophysiology.
- The gut microbiome plays a role in systemic health via the microbiota-gut-brain axis.
- Emerging evidence suggests a link between the gut microbiome and migraine.
Purpose of the Study:
- To review existing literature on the relationship between migraine and the gut microbiome.
- To conduct a meta-analysis on the efficacy of probiotics for migraine prevention.
Main Methods:
- Systematic literature search of Embase and PubMed databases.
- Inclusion of 14 articles based on PRISMA 2020 guidelines for the review.
- Meta-analysis of 2 randomized controlled trials on probiotic supplementation for migraine.
Main Results:
- Observed microbiome alterations in migraine patients correlate with clinical presentation.
- Meta-analysis indicated probiotics significantly reduce migraine frequency (p = 0.003).
- Probiotics showed no significant impact on migraine severity (p = 0.069) or duration (p = 0.149), though frequency reduction approached statistical significance.
Conclusions:
- A correlation exists between migraine and the gut microbiome, suggesting potential therapeutic implications.
- Probiotic supplementation may help alleviate migraine symptoms.
- Further research with larger, consistent studies is necessary due to limitations in current data heterogeneity and methodology.
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