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Was it something I ate? Understanding the bidirectional interaction of migraine and appetite neural circuits
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Orientador(es)
Resumo(s)
Migraine attacks can involve changes of appetite: while fasting or skipping meals are often reported triggers in susceptible individuals, hunger or food craving are reported in the premonitory phase. Over the last decade, there has been a growing interest and recognition of the importance of studying these overlapping fields of neuroscience, which has led to novel findings. The data suggest additional studies are needed to unravel key neurobiological mechanisms underlying the bidirectional interaction between migraine and appetite. Herein, we review information about the metabolic migraine phenotype and explore migraine therapeutic targets that have a strong input on appetite neuronal circuits, including the calcitonin gene-related peptide (CGRP), the pituitary adenylate cyclase-activating polypeptide (PACAP) and the orexins. Furthermore, we focus on potential therapeutic peptide targets that are involved in regulation of feeding and play a role in migraine pathophysiology, such as neuropeptide Y, insulin, glucagon and leptin. We then examine the orexigenic - anorexigenic circuit feedback loop and explore glucose metabolism disturbances. Additionally, it is proposed a different perspective on the most reported feeding-related trigger - skipping meals - as well as a link between contrasting feeding behaviors (skipping meals vs food craving). Our review aims to increase awareness of migraine through the lens of appetite neurobiology in order to improve our understanding of the earlier phase of migraine, encourage better studies and cross-disciplinary collaborations, and provide novel migraine-specific therapeutic opportunities.
Descrição
Funding Information: Margarida Martins-Oliveira acknowledges support from the Funda??o para a Ci?ncia e Tecnologia (FCT) Ph.D. fellowship (SFRH/BD/ 77127/2011). The work was supported by the EUROHEADPAIN European Union FP7 (602633) and the Wellcome Trust. Some illustrations/figures were created, in part, with BioRender.com. The authors apologize to all colleagues whose studies were not discussed or cited in this review because of space limitations. Funding Information: Margarida Martins-Oliveira acknowledges support from the Fundação para a Ciência e Tecnologia (FCT) Ph.D. fellowship (SFRH/BD/ 77127/2011). The work was supported by the EUROHEADPAIN European Union FP7 (602633) and the Wellcome Trust. Some illustrations/figures were created, in part, with BioRender.com. The authors apologize to all colleagues whose studies were not discussed or cited in this review because of space limitations. Funding Information: MMO (margarida.martinsoliveira@nms.unl.pt) declare no competing financial interests. IT (isatav@med.up.pt) declare no competing financial interests. PJG reports, unrelated to this report, grants and personal fees from Amgen and Eli-Lilly and Company, grant from Celgene, and personal fees from Aeon Biopharma, Allergan, Biohaven Pharmaceuticals Inc., Clexio, Electrocore LLC, eNeura, Epalex, GlaxoSmithKline, Impel Neuropharma, Lundbeck, Novartis, Pfizer, Praxis, Sanofi, Santara Therapeutics, Satsuma, and Teva Pharmaceuticals, and personal fees for advice through Gerson Lehrman Group and Guidepoint, fees for educational materials from Massachusetts Medical Society, Medery, Medlink, PrimeEd, UptoDate, WebMD, and publishing royalties from Oxford University Press, and Wolters Kluwer, and for medicolegal advice in headache, and a patent magnetic stimulation for headache (No. WO2016090333 A1) assigned to eNeura without fee. Publisher Copyright: © 2021 The Authors
Palavras-chave
Appetite Glucose Gut-brain Metabolism Migraine Premonitory symptoms General Neuroscience Molecular Biology Clinical Neurology Developmental Biology