Migraine and Obesity: Epidemiology, Mechanisms, and Implications

Authors

  • B. Lee Peterlin DO,

    1. From the Drexel University College of Medicine, Department of Neurology, Philadelphia, PA, USA (B. Lee Peterlin); Drexel University College of Medicine, Department of Pharmacology and Physiology, Philadelphia, PA, USA (B. Lee Peterlin); The David Geffen School of Medicine at UCLA, Clinical Professor of Neurology, Los Angeles, CA, USA (A.M. Rapoport); The New England Center for Headache, Emeritus, Stamford, CT, USA (A.M. Rapoport); INSERM Unit 708 – Neuroepidemiology and University Pierre et Marie Curie, Paris, France (T. Kurth); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA (T. Kurth); Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA (T. Kurth).
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  • Alan M. Rapoport MD,

    1. From the Drexel University College of Medicine, Department of Neurology, Philadelphia, PA, USA (B. Lee Peterlin); Drexel University College of Medicine, Department of Pharmacology and Physiology, Philadelphia, PA, USA (B. Lee Peterlin); The David Geffen School of Medicine at UCLA, Clinical Professor of Neurology, Los Angeles, CA, USA (A.M. Rapoport); The New England Center for Headache, Emeritus, Stamford, CT, USA (A.M. Rapoport); INSERM Unit 708 – Neuroepidemiology and University Pierre et Marie Curie, Paris, France (T. Kurth); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA (T. Kurth); Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA (T. Kurth).
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  • Tobias Kurth MD, ScD

    1. From the Drexel University College of Medicine, Department of Neurology, Philadelphia, PA, USA (B. Lee Peterlin); Drexel University College of Medicine, Department of Pharmacology and Physiology, Philadelphia, PA, USA (B. Lee Peterlin); The David Geffen School of Medicine at UCLA, Clinical Professor of Neurology, Los Angeles, CA, USA (A.M. Rapoport); The New England Center for Headache, Emeritus, Stamford, CT, USA (A.M. Rapoport); INSERM Unit 708 – Neuroepidemiology and University Pierre et Marie Curie, Paris, France (T. Kurth); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA (T. Kurth); Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA (T. Kurth).
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  • Conflict of Interest: Dr. Peterlin has received honoraria and/or grants from GSK, Endo, Merck, OrthoMcNeil, and Pfizer, has a patent for the use of adiponectin modulating agents in migraine, and is an associate editor for Headache. Dr. Rapoport consults for and/or is on the ad boards of Boston Scientific, Nupathe MAP, Pfizer, and Roxro, and is on the speakers bureau of Endo, Merck, and Pfizer. He owns no pharmaceutical stocks and is an editor for Headache. Dr. Kurth has received investigator-initiated research funding as Principal or Co-Investigator from the National Institutes of Health, McNeil Consumer & Specialty Pharmaceuticals, Merck, and Wyeth Consumer Healthcare; he is a consultant to i3 Drug Safety and World Health Information Science consultants, LLC, and has received honoraria from Genzyme, Merck, and Pfizer for educational lectures.

B. Lee Peterlin, Drexel University College of Medicine – Neurology, 245 N. 15th Street, Room 7102, New College Building, Philadelphia, PA 19102, USA.

Abstract

(Headache 2010;50:631-648)

Adipose tissue is a dynamic neuroendocrine organ that is involved in multiple physiological and pathological processes, and when excessive, results in obesity. Clinical and population-based data suggest that migraine and chronic daily headache are associated with obesity, as estimated by anthropometric indices. In addition, translational and basic science research shows multiple areas of overlap between migraine pathophysiology and the central and peripheral pathways regulating feeding. Specifically, neurotransmittors such as serotonin, peptides such as orexin, and adipocytokines such as adiponectin and leptin have been suggested to have roles in both feeding and migraine. In this article, we first review the definition and ascertainment of obesity. This is followed by a review of the clinical and population-based studies evaluating the associations between obesity and chronic daily headache and migraine. We then discuss the central and peripheral pathways involved in the regulation of feeding, where it overlaps with migraine pathophysiology, and where future research may be headed in light of these data.

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