Ebbert Patrick T, Natbony Lauren R
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Integrative Headache Medicine of New York, 308 E 38th St, Suite 200, New York, NY, 10016, USA.
Curr Pain Headache Rep. 2025 Mar 21;29(1):67. doi: 10.1007/s11916-024-01326-3.
This review synthesizes the latest updates in the literature on the connection between fasting and migraine, examining both clinical outcomes and underlying pathophysiological mechanisms.
Although no studies have specifically explored fasting as a therapeutic intervention for migraine, various retrospective analyses suggest that fasting might worsen migraine symptoms in the short term. On the other hand, recent investigations, including several randomized controlled trials, have shown that ketogenic diets significantly reduce the number of migraine days and decrease inflammation markers. Additional research has shown improvements in disability assessments, as indicated by VAS, MIDAS, and HIT-6 scores. These benefits are not replicated by merely administering ketone bodies. Furthermore, genetic studies have found a link between glycemic processing and the occurrence of migraine. There is accumulating evidence that ketogenesis can reduce both the frequency and disability associated with migraine, likely through the reduction of systemic inflammatory markers and diminished cortical excitability. However, the potential benefits of intermittent fasting on migraine prevention remain underexplored and warrant further investigation.
本综述综合了文献中关于禁食与偏头痛之间联系的最新进展，探讨了临床结果和潜在的病理生理机制。
尽管尚无研究专门探讨将禁食作为偏头痛的治疗干预措施，但多项回顾性分析表明，禁食可能在短期内使偏头痛症状恶化。另一方面，最近的研究，包括几项随机对照试验，表明生酮饮食可显著减少偏头痛天数并降低炎症标志物水平。其他研究表明，视觉模拟评分法（VAS）、偏头痛残疾评估量表（MIDAS）和头痛影响测试-6（HIT-6）评分显示，残疾评估有所改善。仅给予酮体并不能复制这些益处。此外，基因研究发现血糖处理与偏头痛的发生之间存在联系。越来越多的证据表明，生酮作用可能通过降低全身炎症标志物水平和减轻皮质兴奋性，减少偏头痛的发作频率和残疾程度。然而，间歇性禁食对预防偏头痛的潜在益处仍未得到充分探索，值得进一步研究。
