Neuroimmunological effects of omega-3 fatty acids on migraine: a review
Chen T-B, Yang, C-C, Tsai I-J, Yang, H-W, Hsu Y-C, Chang CM, Yang, C-P (2024) Frontiers in Neurology 15 https://doi.org/10.3389/fneur.2024.1366372
Web URL: Read this article in full in Frontiers in Neurology here. Free full text is available online
Abstract:
Migraine is a highly prevalent disease worldwide, imposing enormous clinical and economic burdens on individuals and societies.Current treatments exhibit limited efficacy and acceptability, highlighting the need for more effective and safety prophylactic approaches, including the use of nutraceuticals for migraine treatment.
Migraine involves interactions within the central and peripheral nervous systems, with significant activation and sensitization of the trigeminovascular system (TVS) in pain generation and transmission. The condition is influenced by genetic predispositions and environmental factors, leading to altered sensory processing.
The neuroinflammatory response is increasingly recognized as a key event underpinning the pathophysiology of migraine, involving a complex neuro-glio-vascular interplay. This interplay is partially mediated by neuropeptides such as calcitonin gene receptor peptide (CGRP), pituitary adenylate cyclase activating polypeptide (PACAP) and/or cortical spreading depression (CSD) and involves oxidative stress, mitochondrial dysfunction, nucleotide-binding domain-like receptor family pyrin domain containing-3 (NLRP3) inflammasome formation, activated microglia, and reactive astrocytes.
Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), crucial for the nervous system, mediate various physiological functions.
Omega-3 PUFAs offer cardiovascular, neurological, and psychiatric benefits due to their potent anti-inflammatory, anti-nociceptive, antioxidant, and neuromodulatory properties, which modulate neuroinflammation, neurogenic inflammation, pain transmission, enhance mitochondrial stability, and mood regulation.
Moreover, specialized pro-resolving mediators (SPMs), a class of PUFA-derived lipid mediators, regulate pro-inflammatory and resolution pathways, playing significant anti-inflammatory and neurological roles, which in turn may be beneficial in alleviating the symptomatology of migraine.
Omega-3 PUFAs impact various neurobiological pathways and have demonstrated a lack of major adverse events, underscoring their multifaceted approach and safety in migraine management.
Although not all omega-3 PUFAs trials have shown beneficial in reducing the symptomatology of migraine, further research is needed to fully establish their clinical efficacy and understand the precise molecular mechanisms underlying the effects of omega-3 PUFAs and PUFA-derived lipid mediators, SPMs on migraine pathophysiology and progression.
This review highlights their potential in modulating brain functions, such as neuroimmunological effects, and suggests their promise as candidates for effective migraine prophylaxis.
FAB RESEARCH COMMENT:
This review highlights the many different mechanisms by which the long-chain omega-3 fatty acids EPA and DHA might play a role in the prevention and management of migraine.Migraine is a highly prevalent condition, affecting at least 1 in 10 adults worldwide and its personal and societal impact is huge, as the authors note. The best current treatments for this condition are pharmcological, but these all have limited efficacy and acceptability to patients.
The long chain omega-3 EPA and DHA are critical nutrients for brain development and function, but relatively lacking from modern western-type diets. And as this review explains, these omega-3 have numerous biochemical and physiological effects that are highly relevant to what is known about the mechanisms underlying migraine.
Via their numerous derivatives, EPA and DHA each have antiinflammatory actions in both the body and brain (i.e. they can reduce 'neuroinflammation'), and have also been shown to reduce pain sensitivity via several independent mechanisms.
Other possible ways in which they may help to prevent migraine reviewed here include their benefits for metabolic health, mitochondrial stability (and therefore cellular energy metabolism) and mood regulation (as emotional stress can act as a trigger for migraines).
As the authors also note, omega-3 EPA/DHA have also been extensively studied in clinical trials across numerous different conditions, and shown to have no adverse effects.
In conclusion, they propose that omega-3 supplements have considerable promise in the clinical management of migraine.
Update:
This review was submitted for publication in early January, since when another new review - this one involving a network meta-analysis of 40 clinical trials, involving over 6000 patients, has concluded that high-dose omega-3 supplementation is both more effective, and more acceptable, than the best current drug treatments for the prevention of migraine. See:
See also:
And for more information on omega-3 for the allevation of pain, see also the following lists of articles, which are regularly updated:
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