Document Type : Original Article

Authors

1 Department of Clinical Nutrition and Dietetics, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Headache Department, Neurology Ward, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

5 Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Molecular Genetics, School of Biological Sciences, Kharazmi University, Tehran, Iran

6 Department of Clinical Nutrition and Dietetics, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Migraine, a prevalent neurological condition, is recognized as the sixth leading cause of global disability. The proposed mechanism involves a combination of diminished energy reserves and heightened sensory stimulation activating the trigeminovascular system. Thiamine, essential for energy generation in various tissues including the nervous system, is hypothesized to be involved. This study aims to examine the effects of administering a high dose of thiamine to women with episodic migraine.
Methods: A randomized, controlled clinical trial was conducted involving 40 women with episodic migraine. Participants were divided into two groups: one receiving 990 milligrams of thiamine three times daily, and the other receiving 990 milligrams of maltodextrin over 12 weeks. Headache frequency, duration, severity, and disability were evaluated through questionnaires. Initial and final measurements of serum calcitonin gene-related peptide (CGRP) were taken.
Results: Thiamine supplementation resulted in a significant reduction in Migraine Disability Assessment (MIDAS) scores, migraine frequency, duration, and intensity compared to the placebo group. However, both groups experienced a decline in serum CGRP levels, with no significant difference between them.
Conclusion: This study suggests that high-dose thiamine supplementation may offer a beneficial adjunctive treatment for episodic migraine. Further investigations with prolonged intervention periods are necessary to validate these findings.

Keywords

Main Subjects

  1. Steiner TJ, Stovner LJ. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol 2023; 19(2): 109-17.
  2. Wang Y, Wang Y, Yue G, Zhao Y. Energy metabolism disturbance in migraine: From a mitochondrial point of view. Front Physiol 2023; 14: 1133528.
  3. Raggi A, Leonardi M, Bussone G, D'Amico D. A 3-month analysis of disability, quality of life, and disease course in patients with migraine. Headache 2013; 53(2): 297-309.
  4. Olesen J. The role of nitric oxide (NO) in migraine, tension-type headache and cluster headache. Pharmacol Ther 2008; 120(2): 157-71.
  5. Prakash S, Kumar Singh A, Rathore C. Chronic Migraine Responding to Intravenous Thiamine: A Report of Two Cases. Headache 2016; 56(7): 1204-9.
  6. Faraji H, Paknahad Z, Chitsaz A. Dietary Intake of Thiamine in Migraine Patients and Healthy Subjects: a Case-Control Study. Clin Nutr Res 2018; 7(1): 40-7.
  7. Antonio C, Massimo T, Gianpaolo Z, Immacolata PM, Erika T. Oral High-Dose Thiamine Improves the Symptoms of Chronic Cluster Headache. Case Rep Neurol Med 2018; 2018: 3901619.
  8. Vasheghani-Farahani A, Tahmasbi M, Asheri H, Ashraf H, Nedjat S, Kordi R. The Persian, last 7-day, long form of the International Physical Activity Questionnaire: translation and validation study. Asian J Sports Med 2011; 2(2): 106-16.
  9. Zandifar A, Asgari F, Haghdoost F, Masjedi SS, Manouchehri N, Banihashemi M, et al. Reliability and validity of the migraine disability assessment scale among migraine and tension type headache in Iranian patients. Biomed Res Int 2014; 2014: 978064.
  10. Togha M, Rahmanzadeh R, Nematgorgani S, Yari Z, Jahromi SR, Refaeian F. Suppression of menstrual-related migraine attack severity using pyridoxine, thiamine, and cyanocobalamin: a quasi-experimental within-subject design. Arch Neurosci 2020; 7(3): e93103.
  11. Nematgorgani S, Razeghi-Jahromi S, Jafari E, Togha M, Rafiee P, Ghorbani Z, et al. B vitamins and their combination could reduce migraine headaches: A randomized double-blind controlled trial. Curr J Neurol 2022; 21(2): 105-18.
  12. Fila M, Pawłowska E, Blasiak J. Mitochondria in migraine pathophysiology - does epigenetics play a role? Arch Med Sci 2019; 15(4): 944-56.
  13. Gross EC, Lisicki M, Fischer D, Sándor PS, Schoenen J. The metabolic face of migraine - from pathophysiology to treatment. Nat Rev Neurol 15 2019; 15(11): 627-43.
  14. Meents JE, Neeb L, Reuter U. TRPV1 in
    migraine pathophysiology. Trends Mol Med 2010; 16(4): 153-9.
  15. Jiang L, Ma D, Grubb BD, Wang M. ROS/TRPA1/CGRP signaling mediates cortical spreading depression. J Headache Pain 2019; 20(1): 25.
  16. Dhir S, Tarasenko M, Napoli E, Giulivi C. Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults. Front Psychiatry 2019; 10: 207.
  17. Mrowicka M, Mrowicki J, Dragan G, Majsterek I. The importance of thiamine (vitamin B1) in humans. Biosci Rep 2023; 43 (10): BSR20230374.
  18. Depeint F, Bruce WR, Shangari N, Mehta R, O'Brien PJ. Mitochondrial function and toxicity: role of the B vitamin family on mitochondrial energy metabolism. Chem Biol Interact 2006; 163(1-2): 94-112.
  19. Metea MR, Newman EA. Glial cells dilate and constrict blood vessels: a mechanism of neurovascular coupling. J Neurosci 2006; 26(11): 2862-70.
  20. Xu S, Cheng X, Wu L, Zheng J, Wang X, Wu J, et al. Capsaicin induces mitochondrial dysfunction and apoptosis in anaplastic thyroid carcinoma cells via TRPV1-mediated mitochondrial calcium overload. Cell Signal 2020; 75: 109733.