Thread by @KetoCounselor

Migraine, a common neurological disorder, may be a metabolic as much as a neurological disease, with the migraine attack serving as a warning signal to increased oxidative stress and/or hypometabolism. (1/21) #neurotwitter #hypometabolism

Despite being primarily studied in terms of neuro-vasculature and neurotransmission, recent research suggests that migraine's pathogenic mechanisms may be linked to metabolism and mitochondrial dysfunction. (2/21) #mitochondria

Magnetic resonance spectroscopy studies have consistently shown decreased ATP levels and abnormal mitochondrial function in migraineurs, suggesting a metabolic component to the disorder. (3/21)

Early studies have also linked metabolic changes induced by fasting, #glucose, or #insulin administration to triggering migraine attacks in susceptible patients. (4/21)

Riboflavin, CoQ10, magnesium, and alpha-lipoic acid are nutraceuticals that have been shown to prevent migraine attacks, suggesting a link between migraine and metabolism/mitochondrial functioning. (5/21)

Oxidative stress appears to be the common factor among many migraine triggers, and even seemingly unrelated triggers can negatively impact mitochondrial #metabolism and oxidative stress. (6/21)

Activation of transient receptor potential channels in nociceptive nerve terminals provides a mechanism by which migraine triggers that increase oxidative stress could lead to #migraine pain. (7/21)

Brain cells can use #ketone bodies as respiratory substrates, making the #KD an attractive metabolic approach for neurological disorders, including migraine, which may have a #metabolic component. (8/21)

Elevated levels of #ketone bodies have been shown to be well-tolerated for extended periods, making them a promising therapeutic target for complex diseases like migraine that involve multiple pathogenic pathways. (9/21)

@AdrianSotoMota, @DrElenaGross
and others in their research group conducted the first randomized controlled trial exploring the effect of β-hydroxybutyrate (BHB) as a prophylactic agent in episodic migraine patients. (10/21)

@AdrianSotoMota @DrElenaGross The trial design for investigating the effect of β-hydroxybutyrate (BHB) on episodic migraine patients was a double-blind, randomized, placebo-controlled crossover design with 41 participants. #research #science (11/21)

@AdrianSotoMota @DrElenaGross The trial consisted of a four-week run-in period, a first 12-week treatment period, a 4-week washout period, a second 4-week run-in period, and a final 12-week treatment period. (12/21)

@AdrianSotoMota @DrElenaGross The investigational medicinal product (IMP) was 9 gr of D-BHB in powdered calcium-magnesium-salt form, divided into three servings per day, with the placebo group receiving sachets of Mannitol. (13/21)

@AdrianSotoMota @DrElenaGross Clinical measures included the Migraine Disability Test, Headache Impact Test, and blood draws for biomarker and safety analysis. (14/21)

@AdrianSotoMota @DrElenaGross The study collected various biomarkers, including albumin, cortisol, glucose, triglycerides, and thyroid stimulating hormone, among others, for the responder analysis. More details on data collection are available in the study protocol. (15/21)

@AdrianSotoMota @DrElenaGross Out of 32 patients in their study, 9 (28.13%) met criteria for β-hydroxybutyrate (BHB) treatment response, with an average of 5.78 less migraine days compared to placebo. (16/21)

@AdrianSotoMota @DrElenaGross Metabolic markers in BHB supplementation responders differed from non-responders, providing insight into potential blood biomarkers for predicting treatment response to migraine prophylaxis. (17/21)

@AdrianSotoMota @DrElenaGross Their study highlights the importance of classifying sub-groups of migraineurs based on objective biomarkers for improving clinical study designs and developing personalized treatments. (18/21)

@AdrianSotoMota @DrElenaGross This study identified a distinct "inflammatory/metabolic migraine" subgroup with unique metabolic and inflammatory signatures, supporting the need for reassessing existing solutions and testing future interventions. (19/21)

@AdrianSotoMota @DrElenaGross They found that three easily measurable blood markers (hs-CRP, HbA1c, and phosphorus) could assist in personalized metabolic migraine treatments and prophylactic interventions. (20/21)

@AdrianSotoMota @DrElenaGross You can learn more about their study here! 👇Kudos to these researchers for wanting you to know all the ways you can feel better! nature.com/articles/s4159…