Elevated Bone Resorption Markers in Patients With Migraine: A Case Series
Abstract
Dear Editor, Migraine is a debilitating headache characterized by pulsating quality, and is often on one side of the head and aggravated by movement. Excessive bone resorption due to osteoclast activity can lead to diminished bone strength. Although it may appear ambiguous, a recent study by Wu et al.1 suggested a pathophysiological link between osteoporosis and migraine. Magnesium and vitamin D levels are known to be vital for proper bone function, while they may regulate the frequency of migraines2 by shaping nociceptive processes in unmyelinated calcitonin gene-related peptide (CGRP)-positive neurons, a process also influenced by ovarian hormones.3 Inflammatory mediators such as certain interleukins and tumor necrosis factor-α contribute to endothelial dysfunction and pain pathways in migraine,4 and exerts a significant influence on bone turnover that induces osteoporosis. Moreover, inflammatory mediators play roles in activating the trigeminovascular system, which in turn releases proinflammatory substances, particularly CGRP. Elevated CGRP levels have also been found in subjects with osteoporosis and may indirectly regulate osteoclast activity.5 Furthermore, both of these diseases include high prevalence rates of migraine and osteoporosis in patients with inflammatory bowel disease,6 possibly due to multiple factors such as gut microbiota profile, stress hormones, nutrients, and neuropeptides that affect different intestinal bacterial strains.7 Finally, migraine causes…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 19 participants or records.
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