[en] Emerging evidence suggest migraine is a response to cerebral energy deficiency or oxidative stress in the brain. Beta-hydroxybutyrate (BHB) is likely able to circumvent some of the meta-bolic abnormalities reported in migraine. Exogenous BHB was given to test this assumption and, in this post-hoc analysis, multiple metabolic biomarkers were identified to predict clinical improvements. A randomized clinical trial, involving 41 patients with episodic migraine. Each treatment period was 12 weeks long, followed by eight weeks of washout phase / second run-in phase before entering the corresponding second treatment period. The primary endpoint was the number of migraine days in the last 4 weeks of treatment adjusted for baseline. BHB re-sponders were identified (those with at least a 3-day reduction in migraine days over placebo) and its predictors were evaluated using Akaike's Information Criterion (AIC) stepwise boot-strapped analysis and logistic regression. Responder analysis showed that metabolic markers could identify a "metabolic migraine" subgroup, which responded to BHB with a 5.7 migraine days reduction compared to the placebo. This analysis provides further support for a "metabolic migraine" subtype. Additionally, these analyses identified low-cost and easily accessible biomarkers that could guide recruitment in future research on this subgroup of patients.This study is part of the trial registration: ClinicalTrials.gov: NCT03132233, registered on 27.04.2017, https://clinicaltrials.gov/ct2/show/NCT03132233.
Disciplines :
Neurology
Author, co-author :
Gross, Elena C; Division of Pediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland. elena.gross@oxfordalumni.org
Putananickal, Niveditha; Division of Pediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
Orsini, Anna-Lena; Division of Pediatric Neurology, University Children's Hospital Basel (UKBB) & Neurology Department, University Hospital Basel (USB), University of Basel, Basel, Switzerland
Schoenen, Jean ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques
Fischer, Dirk; Division of Pediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
Soto-Mota, Adrian; Metabolic Diseases Research Unit, National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), Tlalpan, Mexico ; School of Medicine, Tecnologico de Monterrey, Mexico City, Mexico
Language :
English
Title :
Defining metabolic migraine with a distinct subgroup of patients with suboptimal inflammatory and metabolic markers.
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