Migraine prevalence in eating disorders and pathophysiological correlations.

The eating disorders (ED): anorexia nervosa (AN) and Bulimia nervosa (BN) are severe psychiatric and somatic conditions occurring mainly in young woman. Although the etiology is largely unknown, same evidences suggest that biological and psychological factors play a relevant role in the pathogenesis, along with monoamine, indole and same hypothalamic hormonal dysfunctions. Migraine is characterized by similar metabolic and psychological anomalies suggesting that a possible relationship exists between the two pathological conditions. In order to understand the possible relationship between migraine and ED, we have investigated the prevalence of migraine and the other primary headaches in a large group of AN and BN patients. In addition, we have studied the role of tyrosine metabolism in the same group of AN and BN young woman sufferers. In particular, we measured plasma levels of elusive amines: tyramine (Tyr) and octopamine (Oct) and catecholamines: noradrenalin (NE), dopamine (DA). The results of this study show that the prevalence of migraine in the woman affected be EA is very high (>75%). The levels of Tyr and DA were higher and levels of NE were lower in the ED patients with respect to the control subject. These biochemical findings suggest that abnormalities of limbic and hypothalamic circuitries play a role in the pathogenesis of ED. The very high prevalence of migraine in our group of ED sufferers and the biochemical profile of migraine, similar to that ED patients have shown in this study, suggest that migraine may constitute a risk factor for the occurrence of ED in the young females. This hypothesis is supported by the onset of migraine attacks that initiated, in the majority of the patients, before the occurrence of ED symptoms.

Eating disorders and headache: coincidence or consequence?

The eating disorders (ED) anorexia nervosa (AN) and bulimia nervosa (BN) are important psychiatric and somatic conditions occurring mainly in young women. The aetiology is unknown, but there are social, biological and psychological factors that play a relevant role in the pathogenesis, along with multiple endocrine abnormalities. Hypothalamic monoamines (especially serotonin), neuropeptides (especially neuropeptide Y and cholecystokinin) and leptin are involved in the regulation of the human appetite. ED share with migraine the same metabolic profile and aspect of psychiatric and psychological conditions. In support of this hypothesis in one study, it has been shown that the incidence of migraine is high in these patients; and it has been shown that the incidence in a female group that suffers from migraine was greater than in the normal population. In order to understand the possible relationship between migraine and ED, we have investigated the incidence of primary headache in a group of AN and BN patients. The result of this study shows that the prevalence of migraine in women affected by AN and BN is very high (75%) in comparison to the general population (12.5% headache incidence in normal population). In most patients the onset of migraine attacks began before or at the same time as the symptoms of AN and BN. We suggest that migraine is a predisposing condition for the occurence of AD in young women.

Study of tyrosine metabolism in eating disorders. Possible correlation with migraine.

In order to understand the possible role of tyrosine metabolism and in particular that of elusive amines in the pathogenesis of eating disorders (ED), we measured the plasma levels of dopamine, noradrenaline, tyramine (Tyr) and octopamine (Oct) in a large group of anorexic and bulimic patients. In comparison to the control group, the levels of nordrenaline were significantly lower and those of dopamine and Tyr higher in the ED patients. The plasma levels of Oct were in the same range in both subject groups. However when comparing the bulimic vs. the anorexic group, the Oct levels were significantly lower in the anorexic group, whereas those of Tyr were significantly higher in the bulimic patients, suggesting that different activation in the metabolism of elusive amines may underlie the shift from the anorexic into the bulimic state. These biochemical findings raise the possibility that abnormalities of the limbic and hypothalamic circuitries play a role in the pathogenesis of ED. In addition, the very high prevalence of migraine (>75%) in our group of ED sufferers, and the biochemical profile(s) reported in migraine, which appear similar to that found in ED patients, suggest that migraine constitutes a risk factor for the occurrence of ED in young females.