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Fat-Free Mass Is Associated with Migraine Disability in Perimenopausal Women: A Pre-Specified Exploratory Analysis of the MEDEA Study

Filippi F, Pez S, Pittino A, Taglialatela A, Lamon E, Kuris F, Gigli GL, Merlino G et al.

2026

54 participants

Abstract

Background: : /Objectives: Migraine is three times more common in women and worsens during perimenopause, a phase in which estrogen fluctuations are accompanied by deterioration in body composition — increased fat mass (FM) and reduced fat-free mass (FFM) — amplifying systemic inflammation. Despite this biological link, body composition is not systematically assessed in perimenopausal migraine management. This pre-specified exploratory analysis of the MEDEA study evaluates whether body composition, measured by bioelectrical impedance analysis (BIA), is associated with migraine disability in perimenopausal women, and secondarily describes changes in body composition during an anti-inflammatory nutritional intervention with prebiotics and probiotics.

Methods:: Single-arm, single-center, prospective interventional study (MEDEA study, Neurological Clinic ASUFC, Udine); the present work is a pre-specified exploratory secondary analysis. Seventeen women (mean age 52 ± 2.6 years) with episodic or chronic migraine, intestinal dysbiosis, and perimenopausal status (STRAW classification) were assessed with Akern BIA at baseline (T0), 3 months (T3), and 6 months (T6). Changes over time were analyzed with the Wilcoxon signed-rank test; correlations with migraine disability with Spearman's rho.

Results:: Over the intervention period, FM decreased selectively (median −1.60 kg at T3, p = 0.001; median −3.00 kg at T6, p < 0.001), with FFM remaining broadly stable. At baseline, higher FFM…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 54 participants or records.

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