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Spring/Summer 2012

Big Thinking on Migraines

Date: May 14, 2012

Big Thinking on Migraines

Migraines run in the family of neurologist Lee Peterlin. She and her sister have both suffered from debilitating headaches—one reason Peterlin is researching causes of the neurological disorder that strikes 30 million Americans.

Scientists have long known that migraine sufferers are significantly more likely to be women of reproductive age. After puberty, body fat makes a significant jump in this population. Could body composition play a role in migraines? Peterlin searched the literature and found research connecting obesity to a five times greater chance of developing chronic migraines and an increase in headaches in migraine sufferers who were sedentary, a potent risk factor for weight gain.

So Peterlin focused her research on proteins that provide a link between obesity and migraine, including adiponectin and leptin, proteins secreted by adipose tissue that modulate immune and inflammatory components such as interleukin-6; tumor necrosis factor-alpha; and nuclear factor kappa beta. Previous studies had shown that each of these compounds changes in concentration in those with either migraine or obesity.

In a small pilot study, Peterlin and her colleagues found significantly elevated levels of adiponectin in chronic migraine sufferers and a trend toward elevation in those with episodic migraine. Peterlin has since focused on further examining the link between migraine and adipokines, as well as other pro-inflammatory compounds also linked with obesity. Knowing that these proteins are all associated with adipose tissue, she and her colleagues are exploring whether the placement of fat—superficial or deep—might also play a role in migraines.

Her studies could help doctors make better use of tricyclic antidepressants, often a treatment of choice. Some drugs in this class can lead to weight gain, while others—including protriptyline—have the opposite effect.

“If a patient is already in the weight danger zone, that drug might be the better choice,” says Peterlin. “Based on our research, taking body status into consideration should be an important factor in determining which drugs a physician prescribes.”  Christen Brownlee