The microbiome, the gut–brain axis and migraine

Abstract

The gut–brain axis refers to the bidirectional biochemical pathways linking the central nervous system with the gastrointestinal tract. Research suggests that changes in the micro-organisms found in the GI tract (the gut microbiota) can affect the brain's physiological, behavioural and cognitive functions. And through this so-called microbiota gut–brain axis it has been suggested that multiple neurological and psychiatric diagnoses (including Parkinson's disease, Alzheimer's disease, anxiety, depression and migraine) may be influenced by the micro-organisms of the gut. Migraine is a common and frequently debilitating condition. It has a global prevalence of approximately 15% and is responsible for millions of lost school and work days globally every month. Migraine is characterised by repeated, severe and protracted headaches, often preceded or accompanied by nausea, sensory hypersensitivity and visual disturbances. Migraine can be managed with analgesic and prophylactic drugs, although these are not always effective and can frequently have significant side effects. Some promising phase I/II studies suggest that certain combinations of probiotics could reduce the frequency and severity of migraine symptoms, with consequent reductions in medication use. Although research into microbiome-related treatments for migraine are in their infancy, further research into the field, including larger, phase III trials, could provide many millions of migraine patients with an alternative to traditional pharmacological means of managing migraine symptoms.