Purpose
Accumulating evidence highlights the importance of microbiota-directed intervention in neuropsychiatric disorders. This study aims to investigate the effects of probiotic supplements as an ...adjunct therapy in combination with Ritalin in children with attention-deficit hyperactivity disorder (ADHD).
Design/methodology/approach
Children with ADHD, aged 6–12 years, who had an intelligent quotient of ≥70 were enrolled in the study. Participants were randomly assigned to either the group that received probiotics or the group that received the placebo in addition to the weight-adjusted dose of Ritalin. Parents were asked to complete the revised Conners Parent Rating Scale–short version (CPRS–RS), and the psychiatrist completed the seven-point Clinical Global Impression–Severity (CGI–S) scale. Two study groups were compared in three time points, including T1 (before intervention), T2 (at the end of fourth week) and T3 (at the end of the eighth week).
Findings
A total of 38 participants completed the study. After eight weeks of intervention, the probiotic group had a significant improvement regarding CPRS–RS scores in T2 (9.4 unit, p = 0.014) and T3 (18.6 unit, p < 0.001), compared to placebo. In addition, children in the probiotic group had 0.7 unit lower CGI in T3 (p = 0.018) than the placebo group. A significant reduction of CGI scores was observed in each interval (T2 vs T1, T3 vs T2 and T3 vs T1; p < 0.05). This significant change in CGI score between intervals was also detected in the placebo group in T2 vs T1 (p = 0.002) and T3 vs T1 (p < 0.001). Mean CPRS scores of the groups were different in T2 and T3 (p = 0.011 and p < 0.001, respectively) and mean CGI scores of the two study groups were different in T3 (p = 0.018).
Originality/value
Eight weeks of supplementation with probiotics had a favorable effect on symptoms and severity of ADHD. Therefore, probiotics as an adjuvant treatment might have a promising efficacy regarding the management of ADHD.
This study aimed to investigate the association between dietary acid load (DAL) and multiple sclerosis (MS), through the potential renal acid load (PRAL) and net endogenous acid production (NEAP) ...scores. In a hospital-based case-control study of 109 patients with MS and 130 healthy individuals, a validated 168-item semi-quantitative food frequency questionnaire and a logistic regression model were used to evaluate the association between the DAL and MS. After adjusting for age (years), gender (male/female), body mass index (Kg/m
), and total calories (Kcal), the MS odds were 92% lower for those in the highest tertile of total plant-based protein (OR: 0.08, 95%CI: 0.03, 0.23;
-value < 0.001) and about four times higher for those in the highest tertile of the PRAL (OR: 4.16, 95%CI: 1.94, 8.91;
-value < 0.001) and NEAP scores (OR: 3.57, 95%CI: 1.69, 7.53;
-value < 0.001), compared to those in the lowest tertile. After further adjusting for sodium, saturated fatty acid, and fiber intake, the results remained significant for total plant-based protein intake (OR: 0.07, 95%CI: 0.01, 0.38;
-value = 0.002). In conclusion, a higher NEAP or PRAL score may be associated with increased odds of MS, while a higher intake of plant-based protein instead of animal-based protein may be protective.
Purpose of Review
The lifetime prevalence of headaches is 96%. Approximately 11% of the adult population worldwide has a migraine headache. Migraine is a complex disorder that is more than a simple ...headache. So far, many underlying mechanisms, i.e. inflammatory, vascular, neurogenic have been hypothesized. In recent years evidences proposed that an energy deficit due to changes in mitochondrial function contributes to migraine pathophysiology as an upstream disorder. Recent insights suggested that the coexistence of sensory-stimuli surplus and energy-reserve shortage activate the trigeminovascular system. Some nutrients are considered as essential elements in mitochondrial bioenergetics and some others are known as natural immuno-modulatory components. Also, evidence showed their beneficial effect in headache prophylaxis and treatment. In present study, we aimed to review the available data in this field.
Recent Findings
Vitamin B group, magnesium, and Coenzyme Q10 (CoQ10) are well-known for their function in mitochondrial energy metabolism. On the other hand, studies support their beneficial role in controlling migraine headache symptoms. For instance, daily intake of 400-milligram riboflavin for 3 months resulted in more than 50% reduction in migraine attacks in more than half of the consumers. According to recent evidence, vitamin D and Omega-3 which are considered as famous immune-modulatory compounds are also reported to be effective in migraine prophylaxis. For example, every 22% reduction in migraine headache occurrence was reported for every 5 ng/ml rise in serum vitamin D.
Summary
Supplementation with vitamin B group, CoQ10, magnesium, vitamin D and Omega-3 could be considered as an effective, less costly strategy in headache/migraine prophylaxis.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Depression, fatigue, and anxiety are three common clinical comorbidities of multiple sclerosis (MS). We investigated the role of physical activity (PA) level and body mass index (BMI) as modifiable ...lifestyle factors in these three comorbidities.
A cross-sectional study was conducted in the MS specialist clinic of Sina Hospital, Tehran, Iran. Demographic and clinical data were collected. BMI was categorized in accordance with the WHO's standard classification. Physical activity (PA) level and sitting time per day were obtained using the short form of the International Physical Activity Questionnaire (IPAQ-SF). Fatigue, anxiety, and depression scores were measured using the Persian version of the Fatigue Severity Scale (FSS), Beck Anxiety Inventory (BAI), and Beck's Depression Inventory II (BDI-II) questionnaires, respectively. The correlation between the metabolic equivalent of tasks (MET), BMI, and daily sitting hours with depression, anxiety, and fatigue were checked using the linear regression test. The normal BMI group was considered a reference, and the difference in quantitative variables between the reference and the other groups was assessed using an independent sample t-test. Physical activity was classified with tertiles, and the difference in depression, anxiety, and fatigue between the PA groups was evaluated by a one-way ANOVA test.
In total, 85 MS patients were recruited for the study. The mean ± SD age of the participants was 39.07 ± 8.84 years, and 72.9% (
: 62) of them were female. The fatigue score was directly correlated with BMI (
: 0.03;
: 0.23) and sitting hours per day (
: 0.01;
: 0.26) and indirectly correlated with PA level (
< 0.01;
: -0.33). Higher depression scores were significantly correlated with elevated daily sitting hours (
: 0.01;
: 0.27). However, the correlation between depression with PA and BMI was not meaningful (
> 0.05). Higher anxiety scores were correlated with BMI (
: 0.01;
: 0.27) and lower PA (
: 0.01;
: -0.26). The correlation between anxiety and sitting hours per day was not significant (
> 0.05). Patients in the type I obesity group had significantly higher depression scores than the normal weight group (23.67 ± 2.30 vs. 14.05 ± 9.12;
: 0.001). Fatigue (32.61 ± 14.18 vs. 52.40 ± 12.42;
: <0.01) and anxiety (14.66 ± 9.68 vs. 27.80 ± 15.48;
: 0.01) scores were significantly greater among participants in the type II obesity group in comparison with the normal weight group. Fatigue (
: 0.01) and anxiety (
: 0.03) scores were significantly different in the three levels of PA, but no significant difference was found in the depression score (
: 0.17).
Our data suggest that a physically active lifestyle and being in the normal weight category are possible factors that lead to lower depression, fatigue, and anxiety in patients with MS.
Objective
To compare the efficacy of celecoxib for treatment of withdrawal headache vs prednisone in patients with medication overuse headache (MOH).
Methods
In this prospective, double‐blind, ...parallel‐group clinical trial, 97 consecutive subjects with MOH were randomized (simple randomization using computer‐generated numbers) for treatment with either 400 mg/day celecoxib (for the first 5 days then decreased at a rate of 100 mg every 5 days) or prednisone 75 mg/day orally (for the first 5 days then tapered off every 5 days). Subjects who met the International Headache Society criteria for MOH were included in the trial. The change in headache days and intake of rescue medication were considered as primary outcomes while the change in headache severity defined as a secondary outcome.
Results
Patients treated with celecoxib experienced lower headache intensity during the first 3 weeks after withdrawal (after 3 weeks, the median of visual analog scale was 3 for patients in celecoxib group vs 4.5 for prednisone group P < .001). However, headache frequency and the need for rescue medication intake were not different between 2 groups.
Conclusion
During withdrawal in MOH, in order to reduce headache days or rescue medication intake, using either of celecoxib or prednisone as a bridge is not different.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Purpose
Diet is recognized as a possible potential factor in migraine pathogenesis. Limited evidence exists on the effect of diet on pediatric migraine, so this paper aims to investigate the ...association between fruit and vegetable consumption and odds of migraine in children.
Design/methodology/approach
The authors conducted a case-control study in tertiary Sina hospital, Tehran, Iran. A hundred children with migraine as case group and 190 sex-matched healthy controls were included in this study. Definite diagnosis of migraine was based on 2018 international classification of headache disorder 3 (ICHD3) criteria. Demographic and anthropometric characteristics were collected. Common dietary intake of participants was obtained using a validated semi-quantitative food frequency questionnaire.
Findings
Children in the migraine group had significantly higher BMI and age compared with the control group (p-value = <0.01). After adjustment for age, gender, BMI and total energy intake, a significant association between higher intake of vegetables in second tertile (OR: 0.47; CI: 0.24-0.92), fruits in third tertile (OR: 0.31; CI:0.14-0.69) and fiber in fourth quartile (OR:0.28; CI:0.095-0.85) was obtained. Controlling for all confounders in Model 3, the odds of migraine, decreased by 50 per cent and 70 per cent as the consumption of vegetables and fruits increased, in the second tertile of vegetables (p-value = 0.04) and the third tertile of fruits (p-value = <0.01).
Originality/value
The findings confirm a plausible protective role of dietary fruits and vegetables against the risk of migraine in children, which can be attributed to the probable effect of dietary fiber.
Introduction
The Mediterranean Dietary Approaches to the Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has been shown to have beneficial neuroprotective effects. The ...purpose of this research was to evaluate the link between the MIND diet adherence and multiple sclerosis (MS), a degenerative neurological illness.
Methods
In a hospital-based case–control setting, 77 patients with relapsing–remitting multiple sclerosis (RRMS) and 148 healthy individuals were recruited. A validated 168-item semi-quantitative food frequency questionnaire was used to assess participants’ dietary intakes and the MIND diet score. A logistic regression model was used to evaluate the association between MIND diet adherence and MS.
Results
There was significant difference between RRMS and control groups in the median (Q1-Q3) of age (years,
P
value < 0.001), body mass index (BMI) (kg/m
2
,
P
value < 0.001), and total intake of calories (kcal,
P
value = 0.032), carbohydrates (g,
P
value = 0.003), animal-based protein (g,
P
value = 0.009), and fiber (g,
P
value = 0.001). Adherence to the MIND diet was associated with a reduced odds of MS adjusted odds ratio (aOR) = 0.10, 95 percent confidence interval (95% CI) = 0.01–0.88,
P
for trend = 0.001. MS odds was significantly lower in the last tertile of green leafy vegetables (aOR = 0.02, 95% CI = 0.00–0.21,
P
value < 0.001), other vegetables (aOR = 0.17, 95% CI = 0.04–0.73,
P
value = 0.001), butter and stick margarine (aOR = 0.20, 95% CI = 0.06–0.65,
P
value = 0.008), and beans (aOR = 0.05, 95% CI = 0.01–0.28,
P
value < 0.001) consumption. While it was significantly higher in the last tertile of cheese (aOR = 4.45, 95% CI = 1.70–11.6,
P
value = 0.003), poultry (aOR = 3.95, 95% CI = 1.01–15.5,
P
value = 0.039), pastries and sweets (aOR = 13.9, 95% CI = 3.04–64.18,
P
value < 0.001), and fried/fast foods (aOR = 32.8, 95% CI = 5.39–199.3,
P
value < 0.001).
Conclusion
The MIND diet and its components, including green leafy vegetables, other vegetables, and beans, seem to decrease the odds of MS; besides butter and stick margarine, the MIND diet's unhealthy components seem to have the same protective effects, while pastries and sweets, cheese, poultry, and fried/fast foods have an inverse effect.
Abstract Migraine headaches are the most prevalent disabling primary headaches, affecting individuals at an active age. Dietary interventions are considered low‐cost and practical approaches to ...migraine prophylaxis. Hence, the present study aimed to assess the association between adherence to the Healthy Eating Index 2015 (HEI‐2015) and migraine headaches. The present case–control study was conducted on 476 newly diagnosed adults with migraine headaches, based on the International Classification of Headache Disorders 3rd edition (ICHDIII criteria(, and 512 healthy controls. Participants' dietary intakes were collected using a validated, 168‐item semi‐quantitative food frequency questionnaire (FFQ). The association between HEI‐2015 and migraine headaches was assessed using logistic regression models. Although the trend was not statistically significant, being in the 4th quantile of the HEI‐2015 was associated with about 50% lower odds of migraine headaches in both primary (adjusted for age and gender) (odds ratios (OR): 0.51, 95% confidence intervals (CI): 0.33, 0.78) and fully adjusted models (additionally adjusted for body mass index (BMI) and total calories) (adjusted OR: 0.50, 95%CI: 0.32, 0.77). Intriguingly, the odds of migraine headaches were significantly higher in those in the last quantile of “Total Fruits,” which is equal to more than 237 g per 1000 kcal (aOR: 2.96, 95%CI: 1.99, 4.41) and “Whole Fruits,” which is equal to more than 233 g per 1000 kcal (aOR: 2.90, 95%CI: 1.94, 4.31). Similarly, higher intakes of “Dairy,” which is equal to more than 138 g per 1000 kcal (aOR: 2.66, 95%CI: 1.71, 4.14), and “Total Protein Foods,” which is equal to more than 259 g per 1000 kcal (aOR: 2.41, 95%CI: 1.58, 3.70), were associated with higher odds of migraine headaches. The current study revealed an indirect association between HEI‐2015 and its components, including “Greens and Beans,” “Whole Grains,” “Refined Grains,” and “Added Sugars” and lower odds of migraine headaches.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Objective
To assess the efficacy and safety of cinnarizine for the prophylaxis of migraine associated vertigo in the vestibular migraine and migraine with brainstem aura.
Background
Vestibular ...migraine and migraine with brainstem aura are two principal clinical syndromes that frequently are associated with vertigo. Since cinnarizine is a well-tolerated calcium channel blocker which has acceptable effect on both vertigo and migraine headache, we carried out this study to evaluate the efficacy and safety of this medication in vestibular migraine and also migraine with brainstem aura associated with vertigo.
Methods
This was a retrospective, single-center, open-label, investigation of the effects of cinnarizine on vestibular migraine and migraine with associated with vertigo. We assessed the change in monthly frequency of vertigo and also frequency, duration and intensity of migraine attacks after one, two and three months of cinnarizine administration.
Results
The mean frequency of vertigo and also the mean frequency, duration and intensity of migraine headaches per month were reduced significantly after three months of cinnarizine therapy (all p < 0.001).
Conclusion
This study suggests that cinnarizine is safe and effective in reducing both headache and vertigo aspects of “migraine plus vertigo” among the patients who suffer from either vestibular migraine or migraine with brainstem aura associated with vertigo.
Purpose
Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare disease with unknown risk factors. The role of oxidative stress and nutritional factors is imprecise in NMOSD development. Therefore, ...this paper aims to evaluate the effects of dietary total antioxidant capacity (TAC) on the odds of NMOSD.
Design/methodology/approach
Dietary TAC was determined in 70 definite NMOSD cases and 164 healthy controls in term of Ferric Reducing Antioxidant Power (FRAP) method. A validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used for dietary assessment. Three multivariate regression models were applied to analyze the odds of NMOSD across the TAC quartiles.
Findings
A significant inverse association was found between dietary TAC and odds of being assigned to the NMOSD group in all three regression models. In the fully adjusted model ORs (95% CI) in the second, third and fourth quartiles of TAC vs the first quartile were as follows: 0.11 (0.04-0.29), 0.05 (0.01-0.16) and 0.01 (0.00-0.05), respectively. Odds of NMOSD also indicated a significant decreasing trend across the quartiles of dietary TAC (p-trend: <0.01). Total energy (p < 0.01) as well as consumption of vegetables (p < 0.01), whole grains (p < 0.01), tea and coffee (p < 0.01), legumes (p < 0.01) and poultry (p < 0.01) significantly increased through the TAC quartiles.
Originality/value
In the present study, a new hypothesis was proposed concerning the influence of dietary TAC on the odds of NMOSD. A diet rich in foods with high TAC can be effective in the modification of the NMOSD odds.
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