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Is Migraine Primarily a Metaboloendocrine Disorder?

  • Migraine and Beyond (R Cowan, Section Editor)
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Abstract

Purpose of the Review

The goals of this review are to evaluate recent studies regarding comorbidity between migraine and different metabolic and endocrine disorders and to discuss the role of insulin resistance as a common pathogenetic mechanism of these diseases.

Recent Findings

Recently, several studies showed that migraine is associated with insulin resistance, a condition in which a normal amount of insulin induces a suboptimal physiological response. All the clinical studies that used the oral glucose tolerance test to examine insulin sensitivity found that, after glucose load, there is in migraine patients a significant increase of both plasmatic insulin and glucose concentrations in comparison with controls. On the contrary, no association was found between migraine and type 2 diabetes, while type 1 diabetes seems to have a protective effect in the disease. Obesity and hypertension were shown to be risk factors for both episodic and chronic migraine. Metabolic syndrome has been recently associated mainly with migraine with aura and is now considered a risk factor also for medication overuse headache. Finally, a bidirectional association between migraine and hypothyroidism has been recently demonstrated, suggesting that common genetic or autoimmune mechanisms underlie both diseases.

Summary

Recent studies showed that insulin receptor signaling and the related physiological responses are altered in migraine and may have a relevant pathogenic role in the disease. Further studies are warranted in order to better elucidate mechanisms underlying insulin resistance in migraine in order to develop new therapeutic strategies for this debilitating disease.

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Authors and Affiliations

  1. Neurology I, Headache Center, Department of Neuroscience, University of Torino, Via Cherasco 15, Turin, 10126, Italy

    Innocenzo Rainero, Flora Govone, Annalisa Gai, Alessandro Vacca & Elisa Rubino

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  1. Innocenzo Rainero
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  2. Flora Govone
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  3. Annalisa Gai
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  4. Alessandro Vacca
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Correspondence to Innocenzo Rainero.

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I. Rainero declares grant support from the Horizon-2020 project and serves on the Editorial Board of Journal of Headache and Pain. Govone F., Gai A., Vacca A., and Rubino E. declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Rainero, I., Govone, F., Gai, A. et al. Is Migraine Primarily a Metaboloendocrine Disorder?. Curr Pain Headache Rep 22, 36 (2018). https://doi.org/10.1007/s11916-018-0691-7

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