Migraine is not something for adults. It also affects children, about 1 in 10, so much so that it leaves its ‘imprints’ on the brain: the real one and the so-called ‘second brain’, that is, the intestine. This is demonstrated by two studies from the Bambino Gesù pediatric hospital in Rome, which investigated the brain structure and the composition of the microbiota of migraineurs, discovering significant differences between their brain or their intestinal bacteria and those of healthy peers. Both studies pave the way for targeted and personalized treatment paths, explain the IRCCS on the occasion of World Brain Day scheduled for today, July 22.
Migraine, the most frequent form of primary headache among children and adolescents, is a neurological pathology that affects approximately 11% of the pediatric population – describe the experts of Bambino Gesù, whose Center for the study and treatment of headaches in developmental age follows 1,500 new cases of migraine-stricken children every year, providing approximately 3,000 services including outpatient visits and day hospital – It is often due to a genetic predisposition, confirmed by the presence of other cases in the family. It can appear at any age, even in the first months of life, although among the youngest the disease does not manifest itself with headaches, but with symptoms such as cyclical vomiting, recurrent abdominal and joint pain, dizziness, stiff neck and car sickness.
The first study, the one on the brain, was conducted in 2 phases by clinicians and researchers from the Developmental Neurology, Functional Neuroimaging and Health Physics units of Bambino Gesù on 100 children and adolescents with migraine and on a control group of 100 peers without migraine. The work, funded by the Ministry of Health and the International Headache Society, allowed to discover “some significant differences between migraine sufferers and healthy people: through magnetic resonance and the analysis technique ‘morphometric similarity’ – it is written in a note – different connection modalities between brain areas were detected, especially those involved in executive functions and in the processing of pain stimuli, and in correspondence with the same areas also a reduction in the thickness of the cerebral cortex. Furthermore, differences in brain connection were observed between males and females”.
“The results tell us that migraine modifies the structure of the brain progressively from childhood – comments Massimiliano Valeriani, head of Developmental Neurology at Bambino Gesù – The evidence of the imprints that the disease leaves on the structure and connection between brain areas indicates the need to intercept, and therefore treat, migraine patients from an early age. Furthermore, the differences between males and females that emerged from our research suggest the adoption of therapeutic plans that also take gender into account, a perspective that has never been taken into consideration even for adults”.
The second study, funded by the Ministry of Health, was conducted by the Developmental Neurology and Microbiomics units of Bambino Gesù on 98 migraine patients between the ages of 6 and 17 and on a control group of 98 peers. The researchers compared stool, urine and blood samples from the two groups. Through the analysis of specific parameters, “significant differences were identified both in the components of the intestinal microbiota and in their functions”. In particular, the note reports, it emerged that “the profile of the microbiota of migraineurs influences some metabolic processes, such as the production of serotonin and tryptophan, implicated in the onset of headaches. Furthermore, the alterations found seem to contribute to intestinal dysbiosis (an imbalance caused by the excess of ‘bad’ bacteria) and to the increase in intestinal permeability, thus fueling the manifestations of the disease”.
“The therapeutic implications of our study are significant,” remarked Laura Papetti, neuro-pediatrician at Bambino Gesù and coordinator of the research. “For patients resistant to common anti-migraine therapies, fecal transplant and dietary therapies based on probiotics and prebiotics could be considered. Further research could clarify the relationship between the alterations of metabolic processes in children with migraine and the response to drugs, paving the way for increasingly targeted and personalized treatments.”
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