Migraine
Conditions
Brief summary
RATIONALE: The prevalence of migraine is higher in patients with various intestinal diseases. An explanation could be that migraine is caused by a 'leaky gut': an increased intestinal permeability that allows food particles to pass the gastrointestinal wall. Probiotics may be able to improve intestinal barrier function. OBJECTIVE: To test whether probiotics, as adjuvant therapy, can reduce incidence and severity of migraine attacks by reducing intestinal permeability. STUDY DESIGN: 12-week placebo-controlled randomized double-blind intervention with selected probiotics. STUDY POPULATION: Adults who experience at least 4 migraine attacks per month. INTERVENTION: Subjects will receive either one daily dose of 2 g of Ecologic® Barrier or 2 grams of the placebo, containing only the carrier material (both provided by Winclove Probiotics). MAIN STUDY PARAMETERS/ENDPOINTS: Incidence and severity of migraine attacks, measured by diaries and validated headache questionnaires will be measured at baseline and after 4, 8, and 12 weeks of probiotic/placebo administration. Secondary, intestinal permeability will be measured by the lactulose/mannitol absorption test in urine (screening, baseline and 12 weeks) and by fecal zonulin (baseline, 4, 8, and 12 weeks). Inflammation will be assessed from blood C-reactive protein and cytokine concentrations (baseline, 4, 8, and 12 weeks). Fecal samples will also be used for microbial analysis.
Interventions
multispecies probiotic product, 2x10-9 cfu/gram
similar appearance as the probiotic product, but without bacteria
Sponsors
Study design
Eligibility
Inclusion criteria
* Subjects confirm to have migraine characterized by : * Recurrent attacks of moderate to severe headaches, often one-sided and pounding, often with nausea and/or vomiting, aggravated by physical activity * Sensitivity for light or sounds is possible but not exclusive. * Attacks last for 4 to 72 hours. * Self-reported frequency of migraine attacks (or days) at least 4 per month * Fairly predictable/stable pattern of migraine attacks (frequency, duration, intensity) * Age ≥ 18 years * Good overall health (self-reported in medical questionnaire)
Exclusion criteria
* Migraine patients who suffer from chronic daily migraine/headaches * Migraine patients who suffer from medication-dependent headaches * Subjects who suffer from cluster headache or tension-type headaches * Subjects who used antibiotics up to two months before the start of the study * Subjects who are unwilling to stop taking probiotics other than study products * Patients with a chronic use of non steroid anti inflammatory drugs (because of increased gut permeability) * Patients with inflammatory bowel diseases (because of increased gut permeability) * Pregnancy or lactation (because of their possible effect on migraine incidence)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Frequency of migraine attacks | 12 weeks |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intestinal permeability | 12 weeks | Lactulose/mannitol in urine, zonulin in serum |
| Inflammation markers. | 12 weeks | pro-inflammatory cytokines in serum |