Bariatric Surgery in Migraine patients: CGRP Level and Weight Loss,Obesity Surgery

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Bariatric Surgery in Migraine patients: CGRP Level and Weight Loss
Obesity Surgery ( IF 2.9 ) Pub Date : 2022-08-03 , DOI: 10.1007/s11695-022-06218-2
Helia Hemasian Etefagh ₁ , Shahab Shahabi Shahmiri _{2,

3,

4} , Hamid Melali ₅ , Masoud Sayadi ₆ , Hossein Ansari ₇ , Arvin Shahzamani ₈ , Mitra Sadat Deyhimi ₁

Affiliation

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.

Graphical abstract

中文翻译：

偏头痛患者的减肥手术：CGRP 水平和体重减轻

背景

肥胖使偏头痛更加普遍和严重。血清降钙素基因相关肽 (CGRP) 水平与偏头痛发作的严重程度相关。尽管已经研究了体重和减肥手术对偏头痛的影响，但 CGRP 在减肥手术后偏头痛缓解中的作用需要更多研究。

方法

这项研究包括患有严重肥胖症的患者，他们是减肥手术的候选人并被诊断患有慢性偏头痛。体重、BMI、过去 3 个月头痛天数、10 点 Likert VAS 头痛严重程度、偏头痛残疾评估量表 (MIDAS) 和偏头痛特定生活质量 (MSQ) 问卷评分以及血清 CGRP 水平在手术前和手术后 6-10 个月内进行评估。

结果

包括 60 名患有严重肥胖的慢性偏头痛患者。95% 的患者在 90 天内报告的发作次数（21 至 8 次， p < 0.001）和头痛的严重程度显着降低（7.7 至 4.8， p < 0.001）；MIDAS（64.4 至 25.5，p < 0.001）和 MSQ 评分（44.6 至 26.8，p < 0.001）和 CGRP 水平（252.7 至 130.1，p < 0.001）在平均随访 7.5 个月后显着降低。MIDAS、MSQ 和 CGRP 的变化与体重相关变量显着相关。