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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Migraine Parameters
Improve after Obesity Surgery |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(ECCC)— Morbidly obese patients with migraine had
significant improvement in headache frequency and severity
following weight-reducing bariatric surgery, Dr. Gal Ifergane
reported April 16 at the annual meeting of the American Academy
of Neurology.
Within 3 months after surgery, all major migraine parameters had
improved significantly. However, longer follow-up is needed to
determine whether the migraine improvement persists and to
examine potential explanations for the improvement, said Dr.
Ifergane of Soroka Medical Center in Beer-Sheva, Israel.
“I believe it is the weight loss that is affecting migraine, not
the surgery,” he continued. “Bariatric surgery helps patients
achieve drastic weight loss in a short period of time, which
isn’t seen with other methods of weight loss. In that respect,
the surgery provides a good model for study. The improvement in
migraine might represent influence of the surgery itself, but I
don’t see how.”
To examine the effect of bariatric surgery on migraine,
investigators studied 105 morbidly obese women, with an average
body mass index of 43, who were scheduled for the
weight-reducing surgery. Screening with a questionnaire revealed
29 patients with migraine.
The migraine patients’ mean age was 34, and 19 (65.5%) had
migraine with aura. The only significant baseline difference
between patients with and without migraine was a higher
prevalence of dysmenorrhea in the migraine group (65.5% vs.
40.5%, P=0.02).
At 90 days’ postsurgical follow-up, migraine severity had
decreased significantly, whether assessed by the Migraine
Induced Disability Scale (MIDAS) or the Headache Impact Test
(HIT6). The average MIDAS score decreased from 21 at baseline to
5 (P<0.001), and the HIT6 mean decreased from 56 to 40
(P<0.001).
The average number of headache days improved from 18 in the
three months before surgery to eight after surgery (P<0.001).
Pain severity, as assessed by a visual analog scale, decreased
from 7.0 to 4.0 (P=0.005). The proportion of patients reporting
that headache interrupted daily activities declined from 26
before surgery to 12 at follow-up (P<0.001).
On average, the patients had lost 10% of their baseline body
weight at 3 months. The amount of weight loss did not correlate
with the likelihood or degree of improvement in migraine
parameters.
“This is the first indication that weight loss in obese patients
with migraine can decrease migraine pain, frequency, and
associated disability,” said Dr. Ifergane.
Potential explanations for the association between weight loss
and migraine improvement include changes in acute inflammatory
response or endocrine function in adipose tissue, improvement of
sleep apnea, and improved general well-being resulting from
weight loss. |
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