Danish Headache Center, Department of Neurology, Rigshospitalet- Glostrup, Glostrup Research Institute, University of Copenhagen, Nordstjernevej 42, 2600, Glostrup, Denmark.
J Headache Pain. 2021 Oct 10;22(1):123. doi: 10.1186/s10194-021-01337-0.
Obesity confers adverse effects to every system in the body including the central nervous system. Obesity is associated with both migraine and idiopathic intracranial hypertension (IIH). The mechanisms underlying the association between obesity and these headache diseases remain unclear.
We conducted a narrative review of the evidence in both humans and rodents, for the putative mechanisms underlying the link between obesity, migraine and IIH.
Truncal adiposity, a key feature of obesity, is associated with increased migraine morbidity and disability through increased headache severity, frequency and more severe cutaneous allodynia. Obesity may also increase intracranial pressure and could contribute to headache morbidity in migraine and be causative in IIH headache. Weight loss can improve both migraine and IIH headache. Preclinical research highlights that obesity increases the sensitivity of the trigeminovascular system to noxious stimuli including inflammatory stimuli, but the underlying molecular mechanisms remain unelucidated.
This review highlights that at the epidemiological and clinical level, obesity increases morbidity in migraine and IIH headache, where weight loss can improve headache morbidity. However, further research is required to understand the molecular underpinnings of obesity related headache in order to generate novel treatments.
肥胖对包括中枢神经系统在内的人体每个系统都有不利影响。肥胖与偏头痛和特发性颅内高压（IIH）都有关。肥胖与这些头痛疾病之间关联的机制仍不清楚。
我们对人类和啮齿动物的证据进行了叙述性综述，以探讨肥胖、偏头痛和 IIH 之间联系的潜在机制。
躯干肥胖是肥胖的一个关键特征，通过增加头痛的严重程度、频率和更严重的皮肤感觉过敏，与偏头痛发病率和残疾增加有关。肥胖也可能增加颅内压，并可能导致偏头痛的头痛发病率，并可能导致 IIH 头痛。减肥可以改善偏头痛和 IIH 头痛。临床前研究强调，肥胖会增加三叉神经血管系统对有害刺激（包括炎症刺激）的敏感性，但潜在的分子机制仍不清楚。
本综述强调，在流行病学和临床水平上，肥胖会增加偏头痛和 IIH 头痛的发病率，而减肥可以改善头痛的发病率。然而，需要进一步的研究来了解肥胖相关头痛的分子基础，以便开发新的治疗方法。
