Ramsden Christopher E, Faurot Keturah R, Zamora Daisy, Palsson Olafur S, MacIntosh Beth A, Gaylord Susan, Taha Ameer Y, Rapoport Stanley I, Hibbeln Joseph R, Davis John M, Mann J Douglas
Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA Division of Gastroenterology and Hepatology, Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, NC, USA Nutrition Research and Metabolism Core, North Carolina Translational Clinical Sciences Institute, University of North Carolina, Chapel Hill, NC, USA Brain Physiology and Metabolism Section, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA Department of Neurology, University of North Carolina, Chapel Hill, NC, USA.
Pain. 2015 Apr;156(4):587-596. doi: 10.1097/01.j.pain.0000460348.84965.47.
Omega-3 and omega-6 fatty acids are precursors of bioactive lipid mediators posited to modulate both physical pain and psychological distress. In a randomized trial of 67 subjects with severe headaches, we recently demonstrated that targeted dietary manipulation-increasing omega-3 fatty acids with concurrent reduction in omega-6 linoleic acid (the H3-L6 intervention)-produced major reductions in headache compared with an omega-6 lowering (L6) intervention. Because chronic pain is often accompanied by psychological distress and impaired health-related quality of life (HRQOL), we used data from this trial to examine whether the H3-L6 intervention favorably impacted these domains. Additionally, we examined the effect of the interventions on the number of cases with substantial physical or mental impairments as defined by cutoff values in the Brief Symptom Inventory (BSI-18), Medical Outcomes Study Short Forms 12 (SF-12), Headache Impact Test (HIT-6), and the number of headache days per month. In the intention-to-treat analysis, participants in the H3-L6 group experienced statistically significant reductions in psychological distress (BSI-18 mean difference: -6.56; 95% confidence interval [CI]: -11.43 to -1.69) and improvements in SF-12 mental (mean difference: 6.01; 95% CI: 0.57 to 11.45) and physical (mean difference: 6.65; 95% CI: 2.14 to 11.16) health summary scores. At 12 weeks, the proportion of subjects experiencing substantial impairment according to cutoff values in the BSI-18, SF-12 physical, HIT-6, and headache days per month was significantly lower in the H3-L6 group. Dietary manipulation of n-3 and n-6 fatty acids, previously shown to produce major improvements in headache, was found to also reduce psychological distress and improve HRQOL and function.
ω-3和ω-6脂肪酸是生物活性脂质介质的前体，据推测可调节身体疼痛和心理困扰。在一项针对67名重度头痛患者的随机试验中，我们最近证明，有针对性的饮食调整——增加ω-3脂肪酸同时减少ω-6亚油酸（H3-L6干预）——与ω-6降低（L6）干预相比，能显著减轻头痛。由于慢性疼痛常伴有心理困扰和健康相关生活质量（HRQOL）受损，我们利用该试验数据来研究H3-L6干预是否对这些方面产生有利影响。此外，我们还研究了干预措施对根据简明症状量表（BSI-18）、医学结局研究简表12（SF-12）、头痛影响测试（HIT-6）中的临界值定义的有严重身体或精神损伤的病例数，以及每月头痛天数的影响。在意向性分析中，H3-L6组的参与者在心理困扰方面有统计学显著降低（BSI-18平均差异：-6.56；95%置信区间[CI]：-11.43至-1.69），SF-12心理（平均差异：6.01；95%CI：0.57至11.45）和生理（平均差异：6.65；95%CI：2.14至11.16）健康总结得分有所改善。在12周时，根据BSI-18、SF-12生理、HIT-6中的临界值以及每月头痛天数，H3-L6组中经历严重损伤的受试者比例显著更低。先前已证明对n-3和n-6脂肪酸进行饮食调整可显著改善头痛，现在发现其还能减轻心理困扰并改善HRQOL和功能。
