Vitamin D serum levels in patients with migraine: A meta-analysis

Liampas, Ioannis; Siokas, Vasileios; Brotis, Alexandros; Dardiotis, Efthimios

doi:10.1016/j.neurol.2019.12.008

Cited by 37 publications

(28 citation statements)

References 63 publications

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“…It is proper that we resort to relatively harmless and efficacious interventions for its successful management. Complementary medicine, 132 dietary interventions, 133,134 and vitamin supplementation 135 appear to fulfil both parameters. Our results suggest a possible role of elevated homocysteine and/or decreased folate in the pathophysiology of migraine, rationalizing, therefore, the investigation of the deployment of Hcy lowering vitamins in subjects suffering from migraine.…”

Section: Discussionmentioning

confidence: 99%

Serum Homocysteine, Pyridoxine, Folate, and Vitamin B12 Levels in Migraine: Systematic Review and Meta‐Analysis

et al. 2020

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Background Migraine, especially migraine with aura (MA), has been linked to increased risk for ischemic cerebrovascular disease. The possible role of elevated serum homocysteine (Hcy, a cause of thrombophilia) in migraine has been demonstrated by several studies. Objective The present study aims to review and meta‐analyze data from studies investigating the difference of serum Hcy and Hcy lowering vitamins between migraine patients and healthy controls (HC), as well as between patients with MA and migraine without aura (MO). Methods Literature search involved MEDLINE, Embase, CENTRAL, Google Scholar, and trial registries. The Newcastle‐Ottawa Scale was used to evaluate the quality of the retrieved studies. Standardized mean differences (SMDs) and 95% confidence intervals (95%CIs) were calculated. Funnel‐plots were utilized for the evaluation of publication bias. Results Overall, 29 (28 case‐control and 1 cross‐sectional) studies were retrieved. Meta‐analysis was indicative of higher Hcy concentration in migraine patients vs HC overall [adults and children: 16 studies, I2 = 81%, SMD = 0.41, 95%CI = (0.20, 0.61)]. Hcy was consistently elevated in adults with migraine [adults: 12 studies, I2 = 76%, SMD = 0.35, 95%CI = (0.15, 0.54); children: 1 study, SMD = 0.37, 95%CI = (−0.05, 0.79)]. Subgroup analyses reproduced the results for both adults with MA [7 studies, I2 = 83%, SMD = 0.37, 95%CI = (0.03, 0.71)] and MO [5 studies, I2 = 84%, SMD = 0.46, 95%CI = (0.03, 0.89)]. Figures for serum folate were lower in the overall comparison of migraine patients with HC [adults and children: 11 studies, I2 = 87%, SMD = −0.36, 95%CI = (−0.68, −0.05); adults: 8 studies, I2 = 6%, SMD = −0.11, 95%CI = (−0.22, 0.01); children: 1 study, SMD = −0.71, 95%CI = (−1.14, −0.29); MA adults: 4 studies, I2 = 44%, SMD = −0.16, 95%CI = (−0.35, 0.04); MO adults: 4 studies, I2 = 47%, SMD = −0.17, 95%CI = (−0.44, 0.10)]. Serum vitamin B12 levels were not different between migraine patients and HC [adults and children: 11 studies, I2 = 88%, SMD = −0.24, 95%CI = (−0.57, 0.09); adults: 8 studies, I2 = 57%, SMD = −0.10, 95%CI = (−0.28, 0.08); children: 1 study, SMD = 0.29, 95%CI = (−0.13, 0.71); MA adults: 4 studies, I2 = 63%, SMD = −0.14, 95%CI = (−0.48, 0.20); MO adults: 4 studies, I2 = 59%, SMD = −0.15, 95%CI = (−0.45, 0.15)]. Serum Hcy was lower in MO than MA [adults and children: 10 studies, I2 = 39%, SMD = 0.30, 95%CI = (0.14, 0.46), adults: 6 studies, I2 = 29%, SMD = 0.21, 95%CI = (0.09, 0.36), children: 1 study, SMD = 0.51, 95%CI = (0.22, 0.80)]. Serum folate and vitamin B12 did not differ between MA and MO. Conclusions Our results suggest that there is a possible link between migraine, mainly MA, and elevated serum Hcy.

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Section: Discussionmentioning

confidence: 99%

Serum Homocysteine, Pyridoxine, Folate, and Vitamin B12 Levels in Migraine: Systematic Review and Meta‐Analysis

et al. 2020

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“…63 Due to their chronic course, it is an increasingly popular trend for investigators to examine the possibility of exploiting alternative medical interventions, with substantially superior tolerability profiles. 64 MT is a complementary medical approach that has demonstrated attractive tolerability properties in the management of PHDs. 25,47 The exact place that it will hold in the treatment of CH remains to be determined by additional high-quality RCTs.…”

Section: Discussionmentioning

confidence: 99%

“…PHDs constitute an admittedly prevalent neurological disorder 62 accountable for severe repercussions 63 . Due to their chronic course, it is an increasingly popular trend for investigators to examine the possibility of exploiting alternative medical interventions, with substantially superior tolerability profiles 64 . MT is a complementary medical approach that has demonstrated attractive tolerability properties in the management of PHDs 25,47 .…”

Section: Discussionmentioning

confidence: 99%

Meta‐analysis of melatonin levels in cluster headache—Review of clinical implications

et al. 2020

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Cluster headache (CH) has been associated with circadian disturbances. The present systematic review examined available evidence for the utilization of melatonin (MT) in CH prophylaxis. First, case‐control studies assessing nocturnal MT or its urine‐expelled metabolite 6‐sulfatoxymelatonin (aMT6s) in CH individuals and healthy controls (HC) were reviewed and meta‐analyzed. Secondly, the results from randomized controlled trials (RCTs) and non‐randomized studies evaluating MT’s use in the prevention of CH were discussed. Literature search included MEDLINE, EMBASE, CENTRAL, PsycINFO, trial registries, Google Scholar, and OpenGrey. Bouts and remissions were assessed separately. Ten case‐control studies (adult participants) were retrieved. Seven evaluated serum MT; meta‐analysis involved only three of them (due to deficient reporting, n: bout = 31, remission = 38, HC = 31). Results were compatible with lower nocturnal serum MT levels during bouts [bout‐HC; FE‐MD = −29.89 pg/mL, 95% CI = (−46.00, −13.78), remission‐HC; FE‐MD = −2.40 pg/mL, 95% CI = (−16.57, 21.38), bout‐remission; RE‐MD = −32.10 pg/mL, 95% CI = (−56.78, −7.42)]. Nocturnal urinary melatonin was appraised in two studies, but reporting issues impeded the capitalization of the results. Nocturnal urine aMT6s was evaluated by two studies (n: bout = 29, remission = 22, HC = 20), and pooled results were indicative of lower aMT6s concentration in CH individuals during both active and inactive periods [bout‐HC; FE‐MD = −9.63 μg/nocturnal urine collection, 95% CI = (−14.40, −4.85), remission‐HC; FE‐MD = −9.12 μg/nocturnal urine collection, 95% CI = (−14.63,‐3.62), bout‐remission; FE‐MD = −0.58 μg/nocturnal urine collection, 95% CI = (−4.58, 3.42)]. Regarding CH prophylaxis, one RCT and two non‐randomized trials were retrieved, involving a total of 41 adult CH individuals (11—episodic, 31—chronic) and rendering the deduction of any conclusions precarious. Overall, available data for the role use of MT in CH are insufficient and inconclusive. Complementary studies evaluating endogenous MT concentrations and MT administration to patients with CH are warranted.

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“…In addition to the mentioned medications, a number of dietary supplements such as minerals and vitamins have been suggested to prevent recurrent migraine attacks. Liampas et al have been conducted 4 important systematic reviews and meta-analyses and provided the evidence for the use of complementary approaches [4][5][6][7]. In these studies, the effects of supplemental pyridoxine, folate, cobalamine, and the serum homocysteine in patients with migraine have been evaluated and possible therapeutic roles have been suggested [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…They also assessed the therapeutic use of exogenous melatonin in migraine [5]. Among the different vitamins, one of the most noted is vitamin D [4,8].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D status in children with migraine: a case-control study

Momen¹,

Riahi²,

Jelodar³

et al. 2020

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Introduction: Vitamin D deficiency has been observed in patients with migraine; however, the results of previous studies are controversial. We aimed to evaluate vitamin D status in a group of children with migraine and to compare them with a group of healthy control. Material and methods: We conducted a prospective case-control study to assess the vitamin D status in children with migraine comparing them with age-and sex-matched healthy controls. Thirty children with migraine and 30 healthy controls were enrolled in the study. The age range was 6-14 years. The vitamin D status was classified as optimal (> 20 ng/ml), insufficient (11-20 ng/ml), and deficient (≤ 10 ng/ml). We also tried to assess the correlation between vitamin D status and the severity and frequency of headache attacks. Results: In the migraine group, five patients (3 girls and 2 boys) had optimal vitamin D, 20 (10 girls and 10 boys) had insufficiency and five (4 girls and 1 boy) were deficient. In the control group, six patients (4 girls and 2 boys) had optimal vitamin D, 19 (8 girls and 11 boys) had insufficiency, and five (4 girls and 1 boy) were deficient. Vitamin D status had no significant difference between groups (p = 0.943). We could not find any correlation between vitamin D status and severity (Pearson correlation, p = 0.513) and frequency (Pearson correlation, p = 0.422) of migraine attacks. Conclusions: Vitamin D insufficiency and deficiency are equally common in children with migraine and healthy controls. We need well designed case control studies with large sample sizes to properly assess the probable pathophysiologic role of vitamin D in children with migraine.

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Vitamin D serum levels in patients with migraine: A meta-analysis

Cited by 37 publications

References 63 publications

Serum Homocysteine, Pyridoxine, Folate, and Vitamin B12 Levels in Migraine: Systematic Review and Meta‐Analysis

Serum Homocysteine, Pyridoxine, Folate, and Vitamin B12 Levels in Migraine: Systematic Review and Meta‐Analysis

Meta‐analysis of melatonin levels in cluster headache—Review of clinical implications

Vitamin D status in children with migraine: a case-control study

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