The association between dietary tryptophan intake and migraine

Jahromi, Soodeh Razeghi; Togha, Mansoureh; Ghorbani, Zeinab; Hekmatdoost, Azita; Khorsha, Faezeh; Rafiee, Pegah; Shirani, Pedram; Nourmohammadi, Morvarid; Ansari, Hossein

doi:10.1007/s10072-019-03984-3

Cited by 20 publications

(16 citation statements)

References 35 publications

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“…In this study, we present a detailed analysis of Trp metabolism including kynurenine, 5-HT and MELA pathways in the peripheral plasma of episodic migraineurs, with special attention to alterations in the interictal/ictal periods and clinical associations. The importance of Trp, 5-HT and MELA has already been identified in migraine [ 8 , 9 , 11 ], however the KP has received little attention in human studies. The KP is the main branch (95%) of Trp catabolism and its several metabolites can influence different pain-related mechanisms, including glutamate-mediated neurotransmission, immunological or antioxidant processes.…”

Section: Discussionmentioning

confidence: 99%

“…KP is the main metabolic route (95%) of tryptophan (Trp) in parallel with the synthesis of serotonin (5-hydroxytryptamine, 5-HT) and melatonin (N-acetyl-5-methoxytrypamine, MELA). Since all three molecules are involved in migraine-related processes [ 6 – 11 ], the question arises whether metabolites of kynurenine contribute to or are affected by these processes. The KP unfolds as follows: firstly, L-kynurenine (KYN) is formed from Trp indirectly during an oxidative step, then three different enzymes determine the generation of further metabolites: 1) kynurenine aminotransferases (KATs) are able to form kynurenic acid (KYNA) from KYN, 2) the kynurenine monooxygenase can generate 3-hydroxykynurenine (3-HK) followed by the formation of xanthurenic acid (XA) and 3-hydroxy-anthranilic acid (3-HANA), and 3) the kynureninase is able to form anthranilic acid (ANA), which can transform to 3-HANA again that generates quinolinic acid (QUINA) and picolinic acid (PICA) in further indirect steps.…”

Section: Introductionmentioning

confidence: 99%

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Clinical relevance of depressed kynurenine pathway in episodic migraine patients: potential prognostic markers in the peripheral plasma during the interictal period

et al. 2021

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Background Altered glutamatergic neurotransmission and neuropeptide levels play a central role in migraine pathomechanism. Previously, we confirmed that kynurenic acid, an endogenous glutamatergic antagonist, was able to decrease the expression of pituitary adenylate cyclase-activating polypeptide 1–38, a neuropeptide with known migraine-inducing properties. Hence, our aim was to reveal the role of the peripheral kynurenine pathway (KP) in episodic migraineurs. We focused on the complete tryptophan (Trp) catabolism, which comprises the serotonin and melatonin routes in addition to kynurenine metabolites. We investigated the relationship between metabolic alterations and clinical characteristics of migraine patients. Methods Female migraine patients aged between 25 and 50 years (n = 50) and healthy control subjects (n = 34) participated in this study. Blood samples were collected from the cubital veins of subjects (during both the interictal/ictal periods in migraineurs, n = 47/12, respectively). 12 metabolites of Trp pathway were determined by neurochemical measurements (UHPLC-MS/MS). Results Plasma concentrations of the most Trp metabolites were remarkably decreased in the interictal period of migraineurs compared to healthy control subjects, especially in the migraine without aura (MWoA) subgroup: Trp (p < 0.025), L-kynurenine (p < 0.001), kynurenic acid (p < 0.016), anthranilic acid (p < 0.007), picolinic acid (p < 0.03), 5-hydroxy-indoleaceticacid (p < 0.025) and melatonin (p < 0.023). Several metabolites showed a tendency to elevate during the ictal phase, but this was significant only in the cases of anthranilic acid, 5-hydroxy-indoleaceticacid and melatonin in MWoA patients. In the same subgroup, higher interictal kynurenic acid levels were identified in patients whose headache was severe and not related to their menstruation cycle. Negative linear correlation was detected between the interictal levels of xanthurenic acid/melatonin and attack frequency. Positive associations were found between the ictal 3-hydroxykynurenine levels and the beginning of attacks, just as between ictal picolinic acid levels and last attack before ictal sampling. Conclusions Our results suggest that there is a widespread metabolic imbalance in migraineurs, which manifests in a completely depressed peripheral Trp catabolism during the interictal period. It might act as trigger for the migraine attack, contributing to glutamate excess induced neurotoxicity and generalised hyperexcitability. This data can draw attention to the clinical relevance of KP in migraine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical relevance of depressed kynurenine pathway in episodic migraine patients: potential prognostic markers in the peripheral plasma during the interictal period

et al. 2021

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“…The data were collected from 2015 to 2018. Detailed information on the study methods has been reported previously [ 26 ]. Our expert headache-specialist neurologist diagnosed migraine headache (episodic and chronic migraine) according to the International Classification of Headache Disorders 3rd edition (ICHDIII) (ICHDIII criteria, beta version) [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

The Association Between Dietary Acid Load and Odds of Migraine: A Case–Control Survey

et al. 2021

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“…Theoretically, it is possible that by increasing the serotonin level, chocolate consumption may induce a migraine attack. Nevertheless, existing studies have not confirmed this theory [45]. Phenylethylamine is also reported as a neurotransmitter that can initiate migraine-type headaches in susceptible individuals.…”

Section: Chocolate and Migraines As A Potential Mechanism Of Actionmentioning

confidence: 99%

“…Tryptophan is an essential serotonin precursor; thus, its depletion, which can occur with decreased dietary tryptophan intake, may increase the susceptibility to migraine-associated symptoms. One study showed that subjects who had a greater intake of tryptophan per day had reduced odds of developing migraine by approximately 54%-60% [45]. This means that chocolate, which contains both tryptophan and serotonin, by increasing serotonin levels, may also decrease the migraine frequency.…”

Section: Chocolate and Migraines As A Potential Mechanism Of Actionmentioning

confidence: 99%

To Eat or Not to eat: A Review of the Relationship between Chocolate and Migraines

et al. 2020

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Migraine is a chronic disorder with episodic attacks, and patients with a migraine often report that certain factors can trigger their headache, with chocolate being the most popular type of food-based trigger. Many studies have suggested a link between chocolate and headaches; however, the underlying physiological mechanisms are unclear. As premonitory symptoms may herald migraine attacks, a question arises regarding whether eating chocolate before a headache is a consequence of a food craving or indeed a real trigger. Here, we aim to summarize the available evidence on the relationship between chocolate and migraines. All articles concerning this topic published up to January 2020 were retrieved by searching clinical databases, including EMBASE, MEDLINE, PubMed, and Google Scholar. All types of studies have been included. Here, we identify 25 studies investigating the prevalence of chocolate as a trigger factor in migraineurs. Three provocative studies have also evaluated if chocolate can trigger migraine attacks, comparing it to a placebo. Among them, in 23 studies, chocolate was found to be a migraine trigger in a small percentage of participants (ranging from 1.3 to 33), while all provocative studies have failed to find significant differences between migraine attacks induced by eating chocolate and a placebo. Overall, based on our review of the current literature, there is insufficient evidence that chocolate is a migraine trigger; thus, doctors should not make implicit recommendations to migraine patients to avoid it.

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The association between dietary tryptophan intake and migraine

Cited by 20 publications

References 35 publications

Clinical relevance of depressed kynurenine pathway in episodic migraine patients: potential prognostic markers in the peripheral plasma during the interictal period

Clinical relevance of depressed kynurenine pathway in episodic migraine patients: potential prognostic markers in the peripheral plasma during the interictal period

The Association Between Dietary Acid Load and Odds of Migraine: A Case–Control Survey

To Eat or Not to eat: A Review of the Relationship between Chocolate and Migraines

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