Information de reference pour ce titreAccession Number: | 00006114-201103290-00006.
|
Author: | Bond, D.S. PhD; Vithiananthan, S. MD; Nash, J.M. PhD; Thomas, J.G. PhD; Wing, R.R. PhD
|
Institution: | From The Miriam Hospital (D.S.B., S.V., J.G.T., R.R.W.), Providence; and Departments of Psychiatry and Human Behavior (D.S.B., J.M.N., J.G.T., R.R.W.) and Surgery (S.V.), Warren Alpert Medical School of Brown University, Providence, RI.
|
Title: | |
Source: | Neurology. 76(13):1135-1138, March 29, 2011.
|
Abstract: | Objectives: Research increasingly suggests that obesity is an exacerbating factor for migraine. However, it is less clear whether weight loss may help to alleviate migraine in obese individuals. We examined whether weight loss after bariatric surgery is associated with improvements in migraine headaches.
Methods: In this prospective observational study, 24 patients who had migraine according to the ID-Migraine screener were assessed before and 6 months after bariatric surgery. At both time points, patients had their weight measured and reported on frequency of headache days, average headache pain severity, and headache-related disability over the past 90 days via the Migraine Disability Assessment questionnaire. Changes in headache measures and the relation of weight loss to these changes were assessed using paired-sample t tests and logistic regression, respectively.
Results: Patients were mostly female (88%), middle-aged (mean age 39.3), and severely obese (mean body mass index 46.6) at baseline. Mean (+/-SD) number of headache days was reduced from 11.1 +/- 10.3 preoperatively to 6.7 +/- 8.2 postoperatively (p < 0.05), after a mean percent excess weight loss (%EWL) of 49.4%. The odds of experiencing a >=50% reduction in headache days was related to greater %EWL, independent of surgery type (p < 0.05). Reductions in severity were also observed (p < 0.05) and the number of patients reporting moderate to severe disability decreased from 12 (50.0%) before surgery to 3 (12.5%) after surgery (p < 0.01).
Conclusions: Severely obese migraineurs experience marked alleviation of headaches after significant weight reduction via bariatric surgery. Future studies are needed to determine whether more modest, behaviorally produced weight losses can effect similar migraine improvements.
Classification of evidence: This study provides Class III evidence that bariatric surgery is associated with reduction of migraine headaches in severely obese individuals.
(C)2011 American Academy of Neurology
|
References: | 1. Bigal ME, Liberman JN, Lipton RB. Obesity and migraine: a population study. Neurology 2006;66:545-550.
2. Bigal ME, Tsang A, Loder E, Serrano D, Reed ML, Lipton RB. Body mass index and episodic headaches: a population-based study. Arch Intern Med 2007;167:1964-1970.
3. Bigal ME, Lipton RB, Holland PR, Goadsby PJ. Obesity, migraine, and chronic migraine: possible mechanisms of interaction. Neurology 2007;68:1851-1861.
4. Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine validation study. Neurology 2003;61:375-382.
5. Stewart WF, Lipton RB, Dowson AJ, Sawyer J. Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology 2001;56:S20-S28.
6. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606-613.
7. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;142:547-549.
8. Subcommittee IHSCT. Guidelines for controlled trials of drugs in migraine: second edition. Cephalalgia 2000;20:765-786.
9. Nicholson R, Bigal M. Screening and behavioral management: obesity and weight management. Headache 2008;48:51-57.
10. Bond DS, Roth J, Nash JM, Wing RR. Migraine and obesity: epidemiology, possible mechanisms, and the potential role of weight loss treatment. Obes Rev Epub 2010 July 28.
|
Language: | English.
|
Document Type: | Articles.
|
Journal Subset: | Clinical Medicine. Life & Biomedical Sciences.
|
ISSN: | 0028-3878
|
NLM Journal Code: | 0401060, nz0
|
DOI Number: | https://dx.doi.org/10.1212/WNL.0...- ouverture dans une nouvelle fenêtre
|
Annotation(s) | |