article#1
Name:Nur Najmina binti mohd jelani
Class:2Al-biruni
College Number:13114
Title:Headache issue


Health Professional Summary, Todd Schwedt, MDIn this issue of Headache, Dr. Peterlin and colleagues provide a review of the literature on the association between obesity and migraine. Understanding this relationship is essential given the high prevalence of obesity in and throughout the world. According to Dr. Peterlin’s article, it is estimated that about 1/3 of adults have total body obesity, while abdominal obesity is found in 61% of women and 42% of men. Total body obesity is associated with an increased risk of transforming from episodic headache to chronic daily headache (Odds ratio 5.28, 95% confidence interval 1.3-21.1), with the greater risk among people with episodic migraine compared to episodic tension-type headache. Furthermore, total body obesity is associated with a higher prevalence of chronic daily headache. Associations between obesity and migraine differ according to reproductive status. During the reproductive years, the prevalence of migraine may be increased in people who are underweight, people with total body obesity, and in those with abdominal obesity. However, in older individuals total body obesity and abdominal obesity does not seem to affect the risk of migraine. Peterlin and colleagues suggest that the link between obesity and migraine is more likely due to functional changes associated with obesity rather than simple structural changes of being overweight. They point out that there is substantial overlap between central and peripheral pathways of feeding and adipose tissue function, and the functional pathways implicated in migraine pathophysiology. Centrally, the hypothalamus plays a role in the regulation of feeding and in migraine pathophysiology, with possible co-mediation of feeding and migraine by serotonin, the orexins, adiponectin and leptin. Peripherally, weight gain can lead to greater activity of the adipocytokines and pro-inflammatory cytokines like TNF-alpha, IL-1 and IL-6, cytokines that have been implicated in migraine pathophysiology
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