Nutrient Status in Patients with Frequent Episodic Tension-Type Headache: A Case-Control Study

I Liampas; S Papathanasiou; N Tsikritsis; V Roka; A Roustanis; T Ntontos; C Kyriakopoulos; M Raptopoulou; G Eythimiadi; V Giakimova-Polyzou; C Kalliora; V Tasios; A Papageorgiou; E Dardiotis

doi:10.1016/j.neurol.2021.05.004

Nutrient Status in Patients with Frequent Episodic Tension-Type Headache: A Case-Control Study

Rev Neurol (Paris). 2021 Dec;177(10):1283-1293. doi: 10.1016/j.neurol.2021.05.004. Epub 2021 Jul 15.

Authors

I Liampas¹, S Papathanasiou², N Tsikritsis³, V Roka³, A Roustanis², T Ntontos³, C Kyriakopoulos⁴, M Raptopoulou⁵, G Eythimiadi³, V Giakimova-Polyzou⁶, C Kalliora⁶, V Tasios², A Papageorgiou³, E Dardiotis⁴

Affiliations

¹ Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece. Electronic address: liampasioannes@gmail.com.
² Health Center of Kalampaka, Prefecture of Trikala, Trikala, Greece.
³ Health Center of Farkadona, Prefecture of Trikala, Trikala, Greece.
⁴ Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.
⁵ Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece; First Department of Internal Medicine, General Hospital of Trikala, Trikala, Greece.
⁶ Health Center of Pyli, Prefecture of Trikala, Trikala, Greece.

PMID: 34275652
DOI: 10.1016/j.neurol.2021.05.004

Abstract

Objective: To investigate the relationship between frequent episodic tension-type headache (FE-TTH) and 25-hydroxyvitamin-D (25(OH)D), folate, vitamin B12, and magnesium.

Design-methods: A prospective case-control study involving adults with FETTH and age-sex matched healthy controls (HC) was performed. Individuals under the responsibility of the three provincial Health Centres of the prefecture of Trikala (Central Greece) were recruited during their regular check-up visits. The relationship between FETTH and serum levels of 25(OH)D, vitamin B12, folate, and magnesium was investigated (primary outcomes). Demographics, daily habits, somatometrics, psychometric and sleep quality measurements, laboratory indices, cardiovascular comorbidities and medications taken were also recorded and compared (secondary outcomes). Potential associations of the above-listed parameters with headache parameters (headache frequency, severity and analgesic consumption) were also examined (secondary outcomes).

Results: Between September and December 2020, 30 patients with FETTH and 30 HC were successfully recruited. Demographics, comorbidities, regular medications, smoking habits, alcohol and coffee consumption, body mass index measurements, markers of systemic inflammation, folate and vitamin B12 levels were similar between the two groups (P>0.05). Lower serum 25(OH)D was both univariately (P<0.001) and multivariately [OR= 0.72, 95%CI=(0.55, 0.94) per 1ng/ml increase] associated with FETTH, while serum magnesium was found lower in FETTH only according to the univariate approach (P=0.036). Higher levels of depression (P=0.050) and anxiety (P=0.020), as well as poor quality of sleep (P=0.008), were univariately associated with FETTH. Only the effect of anxiety remained significant following the multivariate logistic regression [OR=7.90, 95%CI=(1.00, 62.47)]. Headache parameters were not associated with any one of the assessed variables.

Discussion: Lower serum 25(OH)D was related to the presence of FETTH. This finding could imply a potential role for vitamin D in the pathophysiology of TTH.

Keywords: 25(OH)D; Folate; Magnesium; Vitamin B12; Vitamin D.

MeSH terms

Adult
Anxiety
Case-Control Studies
Humans
Nutrients
Sleep Quality
Tension-Type Headache* / epidemiology