Obesity, migraine, and chronic migraine
- 22 May 2007
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 68 (21), 1851-1861
- https://doi.org/10.1212/01.wnl.0000262045.11646.b1
Abstract
Migraine and obesity are associated in several ways. First, both are prevalent and disabling disorders influenced by genetic and environmental risk factors. Second, migraine with aura, as obesity, seems to be a risk factor for cardiovascular events. Finally, large population-based studies suggest that obesity is a risk factor for chronic migraine after adjusting for comorbidities. In this article, we discuss plausible mechanisms that may account for this association. Several of the inflammatory mediators that are increased in obese individuals are important in migraine pathophysiology, including interleukins and calcitonin gene-related peptide (CGRP). These mediators may increase the frequency, severity, and duration of migraine attacks per se, which in turn would cause central sensitization. Repeated central sensitization may be associated with permanent neuronal damage close to the periaqueductal gray area, with poor modulation to pain. Obesity is also a state of sympathetic activation, which may contribute to increase in headache frequency. Furthermore, the levels of adiponectin are decreased in obesity. At low but not normal levels, adiponectin is nociceptive. Shared biologic predisposition may also play a major role. Orexins modulate both pain and metabolism. Dysfunction in the orexins pathways seems to be a risk factor for both conditions. Finally, conditions that are comorbid to both states (e.g., depression, sleep apnea) may also make the relationship between both diseases more complex.This publication has 82 references indexed in Scilit:
- Migraine and Adiponectin: Is There a Connection?Cephalalgia, 2007
- Association Between Obesity and Psychiatric Disorders in the US Adult PopulationArchives of General Psychiatry, 2006
- Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in ChinaInternational Journal of Obesity, 2006
- The metabolic syndrome and adipocytokinesFEBS Letters, 2006
- Adrenomedullin: molecular mechanisms and its role in cardiac diseaseAmino Acids, 2006
- Leukocytosis in obese individuals: possible link in patients with unexplained persistent neutrophiliaEuropean Journal of Haematology, 2006
- Plasma calcitonin gene-related peptide is increased prior to obesity, and sensory nerve desensitization by capsaicin improves oral glucose tolerance in obese Zucker ratsActa Endocrinologica, 2005
- Spinal orexin-1 receptors mediate anti-hyperalgesic effects of intrathecally-administered orexins in diabetic neuropathic pain model ratsBrain Research, 2005
- Calcitonin gene-related peptide in human obesityPeptides, 1991
- The ascending input to the midbrain periaqueductal gray of the primateJournal of Comparative Neurology, 1982