Making migraine easier to stomach: the role of the gut−brain−immune axis in headache disorders

Abstract

Background and PurposeHeadache disorders place a significant burden on the healthcare system, being the leading cause of disability in those under 50 years. Novel studies have interrogated the relationship between headache disorders and gastrointestinal dysfunction, suggesting a link between the gut−brain−immune (GBI) axis and headache pathogenesis. Although the exact mechanisms driving the complex relationship between the GBI axis and headache disorders remain unclear, there is a growing appreciation that a healthy and diverse microbiome is necessary for optimal brain health.MethodsA literature search was performed through multiple reputable databases in search of Q1 journals within the field of headache disorders and gut microbiome research and were critically and appropriately evaluated to investigate and explore the following; the role of the GBI axis in dietary triggers of headache disorders and the evidence indicating that diet can be used to alleviate headache severity and frequency. The relationship between the GBI axis and post‐traumatic headache is then synthesized. Finally, the scarcity of literature regarding paediatric headache disorders and the role that the GBI axis plays in mediating the relationship between sex hormones and headache disorders are highlighted.ConclusionsThere is potential for novel therapeutic targets for headache disorders if understanding of the GBI axis in their aetiology, pathogenesis and recovery is increased.

Association of Blast Exposure in Military Breaching with Intestinal Permeability Blood Biomarkers Associated with Leaky Gut

“…Immunological as well as endocrine, metabolic, and neural pathways are critically involved in the bidirectional communication pathways between gut microbiota and CNS, referred to as the “microbiota–gut–brain” axis. Broadly, the microbiota–gut–brain axis has been implicated in the pathogenesis of neurological disorders (e.g., Alzheimer’s and Parkinson’s), neuropsychiatric disorders (e.g., PTSD and depression), autoimmune disease (e.g., multiple sclerosis), CNS injuries (e.g., stroke, TBI, and spinal cord injury) [ 54 , 55 ], and headaches [ 56 , 57 , 58 , 59 ], with some of these disorders having greater prevalence in our warfighters and Veterans that may be attributable to their military experience [ 29 ]. Notably, combat-deployed service members with concussive blast injury, followed longitudinally, showed reductions in fractional anisotropy through imaging studies, which is indicative of chronic brain injury [ 60 ].…”

Understanding the Biological Relationship between Migraine and Depression

“…However, more research is needed to elucidate and understand the underlying mechanisms. For now, it is hypothesized that alterations in the microbiome may impact the levels of certain neurotransmitters, mainly serotonin, as well as on the peripheral inflammatory state and its reflection in the central nervous system [430,431].…”

The correlation between the frequent intake of dietary migraine triggers and increased clinical features of migraine (analytical cross-sectional study from Egypt)

“…Factors influencing this interaction include inflammatory mediators, gut microbiota, neuropeptides, serotonin pathway, stress hormones, and nutritional substances 4 . Sgro et al 5 refereed that there is potential for novel therapeutic targets for headache disorders if understanding of the GBI axis in their aetiology, pathogenesis and recovery is increased. Because there is a direct connection between the enteric nervous system and the central nervous system 6 , and some nutrients play an effective role in the modification of chronic pain associated with inflammation 7 ; there’s a potential role of foods in triggering, preventing, and managing migraine.…”