Migrânea: aspectos nutricionais, metabólicos e uso do gengibre (Zingiber officinale Rosc.) como estratégia terapêutica

Migraine is a primary headache with high prevalence that causes incapacity. Despite that, its pathophysiology is not fully understood. The objective of this study was to analyze the different factors involved in migraine pathophysiology and new therapeutic possibilities, including: (i) to verify if the diet quality contributes to migraine development and severeness (ii) to test the use of ginger as a migraine prophylactic treatment and (iii) to evaluate changes in biomarkers in migraine patients. For this, we performed two types of studies: cross-sectional study and double-blind placebo-controlled randomized clinical trial in the Headache Clinic of UFMG (Belo Horizonte, MG, Brazil). Patients with episodic migraine, aged between 18 and 60 years who were not taking other prophylactic treatment were paired by gender, age and Body Mass Index (BMI) with individuals without migraine. The groups were compared in relation to diet quality (evaluated by the Healthy Eating Index (HEI), version 2015, adapted for the Brazilian population) and serum concentration of biomarkers. The total diet quality score was lower in migraine patients than in the control group. Migraine patients had higher adiponectin and brain-derived neurotrophic factor (BDNF) serum level. In order to verify the efficacy of ginger in migraine prophylactic therapeutic, patients were randomized 1:1 in two groups that received one capsule containing 200mg of ginger extract or placebo (cellulose) three times a day for three months. A migraine diary, which reported days with headache pain, pain intensity, side effects and use of acute drug, was filled out by the participants. Both groups (ginger and placebo) had significant improvement (42% of patients in ginger group and 39% of patients in placebo group decrease the frequency of migraine attacks in at least 50%). Serum adiponectin level was lower at the end of the treatment among patients who responded to the treatment. The results suggested that nutritional interventions are needed to improve diet quality, as well as verification of the role of adiponectin in pain development, are parameters that should be considered in the migraine treatment. However, the use of ginger as prophylactic migraine treatment should be better investigated, since ginger therapy decreased the migraine attacks frequency as much as placebo