title: Changes in headache frequency in premenopausal obese women with migraine after bariatric surgery: a case series.
abstract: BACKGROUND
  The association between migraine and obesity gives the clinician with an exciting possibility to alleviate migraine suffering through weight-reduction gastric-restrictive operations. We hypothesized that bariatric weight-reduction intervention (gastric banding) will be associated with reduction of migraine burden in this population.
  
  
  METHODS
  A total of 105 women between 18 and 50 years of age, admitted for bariatric surgery between April 2006 and February 2007, were screened for migraine. Twenty-nine with diagnosis of migraine were enrolled into the prospective phase. We followed the migraine pattern of these patients for 6 months post bariatric surgery.
  
  
  RESULTS
  Baseline median migraine frequency was six headache days a month. Post bariatric surgery, the migraine-suffering women reported of a lower frequency of migraine attacks (p < 0.001), shorter duration of the attacks (p = 0.02), lower medication use during the attack (p = 0.005), less non-migraine pain (44.8 vs. 33%, p = 0.05), and post-bariatric surgery reduction in headache-related disability assessed by the MIDAS and HIT-6 scores. There was a reduction in migraine frequency among both episodic (from four to one episodes a month) and chronic (from 16.8 to 8.5 episodes per month) migraine patient cohorts separately and combined.
  
  
  CONCLUSIONS
  Among migraine-suffering premenopausal obese women, we found a reduced frequency of migraine attacks and improvement of headache-related disability post bariatric surgery. Our findings should be interpreted cautiously. The absence of a control group and the non-blinded nature of our small study make it difficult to draw firm conclusions about the causal nature of the headache changes observed in this population. Further study is needed to evaluate the possible specific effects of surgical weight loss on migraine in obese women.
authors.affiliation: Soroka University Medical Center, Israel.
authors.forename: V
authors.initials: V
authors.lastname: Novack
authors.forename: L
authors.initials: L
authors.lastname: Fuchs
authors.forename: L
authors.initials: L
authors.lastname: Lantsberg
authors.forename: S
authors.initials: S
authors.lastname: Kama
authors.forename: U
authors.initials: U
authors.lastname: Lahoud
authors.forename: A
authors.initials: A
authors.lastname: Horev
authors.forename: N
authors.initials: N
authors.lastname: Loewenthal
authors.forename: G
authors.initials: G
authors.lastname: Ifergane
mesh_terms: D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000453:epidemiology*; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D017697:Premenopause; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult