Supplementation with omega-3 (n-3) fatty acids may improve cognitive performance and protect against cognitive decline. However, changes in brain phospholipid fatty acid composition after supplementation with n-3 fatty acids are poorly described. The purpose of this study was to feed increasing n-3 fatty acids and characterise the changes in brain phospholipid fatty acid composition and correlate the changes with red blood cells (RBCs) and plasma in mice. Increasing dietary docosahexaenoic (DHA) and eicosapentaenoic acid (EPA) did not alter brain DHA. Brain EPA increased and total n-6 polyunsaturated fatty acids decreased across treatment groups, and correlated with fatty acid changes in the RBC (r > 0.7). Brain cis-monounsaturated fatty acids oleic and nervonic acid (p < .01) and saturated fatty acids arachidic, behenic, and lignoceric acid (p < .05) also increased. These brain fatty acid changes upon increasing n-3 intake should be further investigated to determine their effects on cognition and neurodegenerative disease.

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Objective This study aims to compare the management practices of a headache specialist with non‐headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuroimaging, and short‐term outcomes are compared in children treated by the two groups of physicians. Methods A retrospective cohort study was conducted by utilizing the electronic medical records of children 3‐18 years of age with migraine, who were evaluated at a tertiary care children's hospital from 2016 to 2018. Results Of the 849 patients who met the study criteria, 469 children were classified as having chronic migraine or high‐frequency episodic migraine and were followed‐up on at least 1 occasion by the neurologists. Imaging was obtained in 66.5% of all children with migraine. The headache specialist used 5‐HT agonists (“triptans”) for migraine management in 56.7% (76/135) of cases compared to non‐headache specialists who prescribed them in 28.7% (96/334) of cases (P < .001). Of the children with chronic migraine, the headache specialist evaluated 135 patients while the non‐headache specialists treated 334 children. Non‐headache specialists prescribed prophylaxis in the form of natural supplements more frequently (63.8% of cases) compared to the headache specialist (38.5% of children) (P < .001). Moreover, prophylaxis with prescription drugs was utilized more often by headache specialist (66.7%) than non‐headache specialists (37.4%) (P < .001). Conclusions Imaging appears to be commonly recommended by both headache specialists and non‐headache specialists in children with migraine. The headache specialist was more likely to use triptans as rescue medications for pediatric migraine. Outcomes in the short‐term were not statistically different whether children were being managed by the headache specialist or the non‐headache specialists.

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Docosahexaenoic acid (DHA) constitutes a large portion of the brain and nervous tissue and is necessary for cognitive function and development. Evidence suggests that supplementation with omega‐3 (n‐3) fatty acids may improve cognitive performance and be protective against cognitive decline. However, the changes in brain phospholipid fatty acid composition after supplementation with n‐3 fatty acids are poorly described. The objective of this study was to 1) investigate how increasing dietary eicosapentaenoic acid (EPA)+DHA influences brain fatty acid composition, and 2) determine if the red blood cell (RBC), as a biomarker, reflects dietary induced fatty acid changes in the brain. Mice were fed fish oil with increasing EPA+DHA concentrations, equivalent to recommendations by the American Heart Association on a percent of energy (%en) basis (0.1%, 0.675%, and 1.8% of total energy from EPA+DHA in the diet). Whole brain and blood samples were collected, phospholipids were isolated, and fatty acid methyl esters were quantified using gas chromatography. Brain, RBC, and plasma fatty acid levels were reported as a % of total fatty acids, and the changes in phospholipid fatty acid composition of the brain were investigated in relation to RBCs and plasma. Increasing dietary supplementation of fish oil enriched with EPA+DHA did not alter brain DHA, where mean % of total remained at 17% of the total fatty acid composition and only fluctuated by ± 0.3% between the control mice and the mice fed the 1.8%en EPA+DHA diet. However, brain EPA significantly increased from 0.02% to 0.10% and total n‐6 polyunsaturated fatty acids significantly decreased from 12.5% to 8.1% when comparing the control mice and highest dietary treatment group, respectively. These changes in EPA and total n‐6 fatty acids in the brain were correlated with changes in the RBC and plasma phospholipid compositions (r > 0.8). In addition, brain cis‐monounsaturated (MUFA) fatty acids oleic, eicosenoic, and nervonic acid (p < 0.0001) and saturated fatty acids arachidic, behenic, and lignoceric acid (p < 0.05) increased with increasing dietary EPA+DHA. Delta‐5‐desaturase enzyme activity estimates (EAEs) significantly increased and stearoyl‐CoA desaturase n‐7 EAEs significantly decreased across treatment groups in the brain, suggesting fatty acid metabolism in the brain may be altered with increasing dietary EPA+DHA. In conclusion, increasing dietary EPA+DHA did not alter DHA in the brain, but did significantly change brain EPA, MUFA, and long chain saturated fatty acid levels in phospholipids. Since changes in these fatty acids levels in the brain are not well described, further research should investigate how increasing the intake of DHA and EPA may affect cognition and neurodegenerative disease.