Is migraine a risk factor for the occurrence of eating disorders? Prevalence and biochemical evidences

Abstract

The eating disorders (ED), anorexia nervosa (AN) and bulimia nervosa (BN), are severe psychiatric and somatic conditions occurring mainly in young woman. Although the aetiology is largely unknown, same evidences suggest that biological and psychological factors play a relevant role in the pathogenesis, along with monoamine, indole and same hypothalamic hormonal dysfunctions. Migraine is characterized by similar metabolic and psychological anomalies suggesting that a possible relationship exists between the two pathological conditions. To understand the possible relationship between migraine and ED, we have investigated the prevalence of migraine and the other primary headaches in a large group of AN and BN patients. In addition, we have studied the role of tyrosine metabolism in the same group of AN and BN young woman sufferers. In particular, we measured plasma levels of elusive amines: tyramine (Tyr) and octopamine (Oct) and catecholamines: noradrenalin (NE), dopamine (DA). The results of this study show that the prevalence of migraine in the woman affected by ED is very high (<75 %). The levels of Tyr and DA were higher and levels of NE were lower in the ED patients in respect to the control subjects. These biochemical findings suggest that abnormalities of limbic and hypothalamic circuitries play a role in the pathogenesis of ED. The very high prevalence of migraine in our group of ED sufferers and the biochemical profile of migraine, similar to that of ED patients shown in this study, suggest that migraine may constitute a risk factor for the occurrence of ED in young females. This hypothesis is supported by the onset of migraine attacks that initiated, in the majority of the patients, before the occurrence of ED symptoms.

Association between eating disorders and migraine may be explained by major depression

“…Women with a lifetime diagnosis of an eating disorder were twice as likely to report a history of migraine as were women from the general population: thus the association between migraine and eating disorders suggested by previous studies was confirmed. 14,15 However, this relationship appeared to be mediated by MDD. We observed that women with both an eating disorder and MDD, had a very high prevalence of migraine (36%).…”

“…14 In another study, 74% of eating disorder inpatients reported migraine. 15 Although both studies lacked a well-defined control population, the reported prevalences clearly exceed those in the general population. A third study did not find an increased prevalence of migraine among eating disorder patients, 16 but the control group was genetically related to the probands (sisters) and thus not suitable for assessing true populationlevel risk.…”

“…A tentative link has also been established between eating disorders and migraine: in a small clinical study, 88% of female migraine patients reported dieting, 59% binge eating, and 26% self‐induced vomiting . In another study, 74% of eating disorder inpatients reported migraine . Although both studies lacked a well‐defined control population, the reported prevalences clearly exceed those in the general population.…”

Metabolic and Neuropsychiatric Effects of Calorie Restriction and Sirtuins

“…One of the most severe disorders reminiscent of CR is anorexia nervosa (AN), which has the highest rate of mortality among all mental disorders (97) and is the most prevalent in young women (98). From the physiological and psychological points of view, there are common features between people suffering from AN and those practicing CR (28, 99).…”

Neuroendocrine signaling modulates specific neural networks relevant to migraine

“…Moreover, a higher migraine prevalence in metabolic syndrome patients was demonstrated comparing to the general population (Guldiken et al, 2009). On the other hand, there is also a potential association with eating disorders, with a high prevalence of migraine in woman affected by anorexia or bulimia nervosa (D'Andrea et al, 2012). In rodents, neuropeptides like orexin and neuropeptide Y involved in the regulation of feeding have been proposed to regulate the trigeminovascular system (Hoffmann et al, 2015, Holland et al, 2006, Martins-Oliveira et al, 2016).…”