The effects of a multispecies probiotic on migraine and markers of intestinal permeability–results of a randomized placebo-controlled study

• Published in: European journal of clinical nutrition Vol. 71; no. 12; pp. 1455 - 1462
• Main Authors: de Roos, N M, van Hemert, S, Rovers, J M P, Smits, M G, Witteman, B J M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-12-2017; Nature Publishing Group
• Subjects: 692/308/575; Adolescent; Adult; Afdeling Humane voeding; Aged; Analysis; Biological markers; Biomarkers - blood; C-reactive protein; C-Reactive Protein - metabolism; Care and treatment; Chair Nutrition and Disease; Clinical Nutrition; Development and progression; Diaries; Diet therapy; Digestive organs; Double-Blind Method; Endotoxins; Epidemiology; Feces - microbiology; Female; Gastrointestinal diseases; Gastrointestinal Microbiome; Headache; Health aspects; HNE Nutrition and Disease; HNE Voeding en Ziekte; Human Nutrition; Human Nutrition & Health; Human Nutrition (HNE); Humane Voeding; Humane Voeding & Gezondheid; Humans; Inflammation; informatie portalen; Interleukin 10; Internal Medicine; Intestine; Intestines - microbiology; Intestines - physiology; ITIS Research and Library; Lactulose; Male; Mannitol; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Migraine; Migraine Disorders - blood; Migraine Disorders - therapy; Nutrition and Disease; original-article; Patients; Permeability; Physiological aspects; Pilot Projects; Placebos; Probiotics; Probiotics - administration & dosage; Public Health; Surveys and Questionnaires; Treatment Outcome; Tumor necrosis factor-α; Voeding en Ziekte; Young Adult; Netherlands
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2017.57

Background/Objectives:
Migraine, associated with several gastrointestinal disorders, may result from increased intestinal permeability, allowing endotoxins to enter the bloodstream. We tested whether probiotics could reduce migraine through an effect on intestinal permeability and inflammation.
Subjects/Methods:
In total, 63 patients were randomly allocated to the probiotic (
n
=31) or the placebo group (
n
=32). Participants ingested a multispecies probiotic (5x10
9
colony-forming units) or placebo daily for 12 weeks. Migraine was assessed with the Migraine Disability Assessment Scale (MIDAS), the Headache Disability Inventory (HDI) and headache diaries. At baseline and 12 weeks, intestinal permeability was measured with the urinary lactulose/mannitol test and fecal and serum zonulin; inflammation was measured from interleukin (IL) -6, IL-10, tumor necrosis factor-α and C-reactive protein in serum.
Results:
The MIDAS migraine intensity score significantly decreased in both groups (
P
<0.001) and the HDI score significantly decreased in the probiotic group (
P
=0.032) and borderline in the placebo group (
P
=0.053). In the probiotics group, patients had a median of 6 migraine days in the first month, 4 in the second month (
P
=0.002) and 5 in the last month, which was not significantly different from the 5, 4, and 4 days in the placebo group. A ⩾2day reduction in migraine days was seen in 12/31 patients in the probiotics group versus 7/29 in the placebo group (ns). Probiotic use did not significantly affect medication use, intestinal permeability or inflammation compared to placebo.
Conclusions:
In this study, we could not confirm significant benefit from a multispecies probiotic compared to a placebo on the outcome parameters of migraine and intestinal integrity.