Evaluation of the intestinal microbiotas of patients with migraine and tension-type headache

EVALUATION OF THE INTESTINAL MICROBIOTAS OF PATIENTS WITH MIGRAINE AND TENSION-TYPE HEADACHE Objectives: Migraine and tension-type headache are common diseases, and their pathogenesis is still not clearly elucidated. The term gut-brain axis refers to the bidirectional relationship between the gastrointestinal tract and the brain. Intestinal microbiota refers to the trillions of microorganisms living in the intestine, and microbiome refers to the complete collection of genes of these intestinal microbes. In our study, it was aimed to evaluate the intestinal microbiota of migraine and tension-type headache patients by comparing them with healthy volunteers, to elucidate the pathogenesis of migraine and tension-type headache patients, and to lay the groundwork for the development of new treatment strategies. Materials and Methods: Our study is a prospective cohort and following the approval of the ethics committee, patients aged 30-40 years old, diagnosed with migraine and TTH according to ICHD-3, who applied to Aydın Adnan Menderes University Hospital Neurology outpatient clinic were included. Criteria for inclusion in the study were determined as having an additional neurological disease, a history of malignancy, a history of autoimmune disease, the presence of an active infection, being diagnosed with DM, having a BMI>30, and having used antibiotics, probiotics, or prebiotics in the last month. 27 cases were included in the migraine group, 29 cases in the TTH group, and 28 cases in the control group. Samples were taken from the patients in sterile stool tubes and stored at -80 centigrade degrees. 16 S rRNA metagenomic analyzes were performed. Results: In our study, when the intestinal microbiome of the Migraine group, TTH group and control group, which overlapped in terms of age and gender, was evaluated; It was determined that the lowest level of alpha diversity was in the migraine group. While a total of 9 phyla, 47 families and 102 genera were determined in the migraine group, this number was determined as 10, 51 and 115 in the TTH group, and 10, 52 and 119 in the control group, respectively. Accordingly, it was understood that there was a significant difference between the alpha diversity of the migraine group and the control group and that bacterial diversity at the taxon level decreased in migraine patients. No significant difference was seen in the TTH group. When the control and migraine groups were compared at the genus level, the difference in beta diversity between the two groups was found to be very significant (p <0.0001). When the control and migraine groups were compared in terms of beta diversity at the family level, the difference was found to be significant (p = 0.0219). When the beta diversity between the control and the TTH group was compared at the genus level, the difference was not found to be significant (p < 0.0982). When family-level beta diversity was compared between the control and TTH group, the difference was found to be insignificant. (p<0.315). Conclusion: Our study revealed a significant decrease in the diversity of genera in the intestinal microbiota of migraine patients; this highlighted the importance of maintaining genus diversity to improve intestinal microecosystem stability. In addition, migraine patients can be supplemented with appropriate specific probiotics to treat intestinal dysbiosis or prevent intestinal disorders, which can reduce the occurrence of migraine attacks. Key words: Migraine, Tension-Type Headache, Microbiota, Microbiome.