Zamora Daisy, Kenney Kimbra, Horowitz Mark, Cole Wesley R, MacIntosh Beth A, Arrieux Jacques P, Dunlap Margaret, Palsson Olafur S, Davis Cora, Moore Carol B, Rivera Wanda, Werner J Kent, Diaz-Arrastia Ramon, Domenichiello Anthony F, Nara Pranavi, Taha Ameer Y, Sylvestre Duncan A, Ramsden Chris E, Faurot Keturah R
Department of Physical Medicine & Rehabilitation, University of North Carolina, Chapel Hill, North Carolina, USA.
Lipid Peroxidation Unit, Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA.
J Neurotrauma. 2025 Jul 2. doi: 10.1089/neu.2025.0126.
Targeted manipulation of dietary omega-3 and omega-6 fatty acids has previously been shown to decrease nontraumatic headaches in controlled trials. This study assessed the effects of a diet high in omega-3 fatty acids and low in omega-6 linoleic acid (H3L6 diet) on headache frequency and severity, headache impact, and plasma nociceptive mediators in a persistent post-traumatic headache (pPTH) population. One hundred and twenty-two participants with pPTH were randomized 1:1 to 12 weeks of either the H3L6 ( = 62) or a control (n = 60) diet. primary end-points were the plasma levels of the antinociceptive docosahexaenoic acid (DHA) derivative 17-hydroxy-DHA and the Headache Impact Test (HIT-6) score. Secondary end-points included headache days/month and average daily headache pain intensity (0-10 scale). Statistical analyses followed intention-to-treat principles and were adjusted for baseline values. Relative to the control group, the H3L6 group significantly reduced headache days/month (-2.1, 95% confidence interval [CI]: -3.5 to -0.8, = 0.002) and average headache intensity (-0.9, 95% CI: -1.2 to -0.5, < 0.001) and increased circulating 17-hydroxy-DHA (nanograms/milliliter; difference 0.07, 95% CI: 0.02-0.11, = 0.003), although it did not significantly improve HIT-6 scores (-1.6, 95% CI: -4.0 to 0.8, = 0.18). In conclusion, the H3L6 diet reduced headache pain and increased antinociceptive mediators, supporting its potential as an adjunct nonpharmacological pPTH therapy.
在对照试验中，此前已证明对膳食ω-3和ω-6脂肪酸进行靶向调控可减少非创伤性头痛。本研究评估了富含ω-3脂肪酸且低ω-6亚油酸的饮食（H3L6饮食）对创伤后持续性头痛（pPTH）人群的头痛频率和严重程度、头痛影响以及血浆伤害感受介质的影响。122名pPTH参与者按1:1随机分为两组，分别接受12周的H3L6饮食（n = 62）或对照饮食（n = 60）。主要终点是抗伤害感受性二十二碳六烯酸（DHA）衍生物17-羟基-DHA的血浆水平和头痛影响测试（HIT-6）评分。次要终点包括每月头痛天数和每日平均头痛疼痛强度（0-10分制）。统计分析遵循意向性分析原则，并对基线值进行了调整。相对于对照组，H3L6组显著减少了每月头痛天数（-2.1，95%置信区间[CI]：-3.5至-0.8，P = 0.002）和平均头痛强度（-0.9，95%CI：-1.2至-0.5，P < 0.001），并提高了循环中的17-羟基-DHA水平（纳克/毫升；差异为0.07，95%CI：0.02 - 0.11，P = 0.003），尽管它并未显著改善HIT-6评分（-1.6，95%CI：-4.0至0.8，P = 0.18）。总之，H3L6饮食减轻了头痛疼痛并增加了抗伤害感受介质，支持其作为pPTH辅助非药物治疗的潜力。
