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Bariatric Surgery in Migraine patients: CGRP Level and Weight Loss

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Abstract

Background

Obesity makes migraine more prevalent and severe. Serum level of calcitonin gene-related peptide (CGRP) is associated with the severity of migraine attacks. Although the effect of weight and bariatric surgery has been studied on migraine, the role of CGRP in migraine remission after weight loss surgery needs more investigation.

Methods

Patients with severe obesity who were bariatric surgery candidates and had been diagnosed with chronic migraine were included in this study. Weight, BMI, number of days with headache in the past 3 months, and severity of headaches in 10-point Likert VAS, Migraine Disability Assessment Scale (MIDAS) and Migraine Specific Quality of life (MSQ) questionnaire scores, and serum CGRP levels were evaluated before and within 6–10 months after surgery.

Result

Sixty patients with chronic migraine with severe obesity were included. Ninety-five percent of patients reported a significantly lower number of attacks (21 to 8, p < 0.001) and severity of headaches within 90-day (7.7 to 4.8, p < 0.001); MIDAS (64.4 to 25.5, p < 0.001) and MSQ scores (44.6 to 26.8, p < 0.001) and CGRP level (252.7 to 130.1, p < 0.001) were significantly reduced after surgery with a mean follow-up of 7.5 months. Changes in MIDAS, MSQ, and CGRP were significantly associated with weight-related variables.

Conclusion

Bariatric surgery decreases the frequency of migraine attacks, lessens the severity of headaches, and improves the quality of life and disability as well as CGRP plasma levels, suggesting CGRP as a possible etiology in the migraine-obesity link.

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Acknowledgements

We appreciate the support provided by our center of excellence for bariatric surgery and the department of neurology

Author information

Authors and Affiliations

  1. Department of Neurology, Alzahra University Hospital, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 81746-73461, Iran

    Helia Hemasian Etefagh & Mitra Sadat Deyhimi

  2. Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

    Shahab Shahabi Shahmiri

  3. Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran

    Shahab Shahabi Shahmiri

  4. Iran National Center of Excellence for Minimally Invasive Surgery Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Shahab Shahabi Shahmiri

  5. Department of Surgery, Amin Hospital, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran

    Hamid Melali

  6. Department of Surgery, Al-Zahra Hospital, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran

    Masoud Sayadi

  7. Department of Neuroscience, Kaizen Brain Center, University of California, San Diego, USA

    Hossein Ansari

  8. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Arvin Shahzamani

Authors
  1. Helia Hemasian Etefagh
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Correspondence to Mitra Sadat Deyhimi.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was conducted after receiving its ethical approval from the IRB and has the registration number “IR.MUI.MED.REC.1399.305.”

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Informed consent was obtained from all individual participants included in this study.

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The authors declare no competing interests.

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Key points

• Migraine headaches are more prevalent and severe among people with obesity.

• Bariatric surgery decreases the frequency and severity of headaches.

• CGRP plasma levels decrease 6–10 months after bariatric surgery.

• CGRP level reduction can be responsible for the improvements in migraine symptoms.

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Etefagh, H.H., Shahmiri, S.S., Melali, H. et al. Bariatric Surgery in Migraine patients: CGRP Level and Weight Loss. OBES SURG 32, 3635–3640 (2022). https://doi.org/10.1007/s11695-022-06218-2

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  • DOI: https://doi.org/10.1007/s11695-022-06218-2

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