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  • The effects of vitamin supplementation and MTHFR (C677T) genotype on homocysteine-lowering and migraine disability

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    Author(s)
    Lea, Rod
    Colson, Natalie
    Quinlan, Sharon
    Macmillan, John
    Griffiths, Lyn
    Griffith University Author(s)
    Colson, Natalie J.
    Year published
    2009
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    Abstract
    Background Migraine is a prevalent and debilitating disease that may, in part, arise because of disruption in neurovascular endothelia caused by elevated homocysteine. This study examined the homocysteine-lowering effects of vitamin supplementation on migraine disability, frequency and severity and whether MTHFRC677T genotype influenced treatment response. Methods This was a randomized, double-blind placebo, controlled trial of 6 months of daily vitamin supplementation (i.e. 2mg of folic acid, 25mg vitamin B6, and 400 lg of vitamin B12) in 52 patients diagnosed with migraine with aura. Findings Vitamin supplementation ...
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    Background Migraine is a prevalent and debilitating disease that may, in part, arise because of disruption in neurovascular endothelia caused by elevated homocysteine. This study examined the homocysteine-lowering effects of vitamin supplementation on migraine disability, frequency and severity and whether MTHFRC677T genotype influenced treatment response. Methods This was a randomized, double-blind placebo, controlled trial of 6 months of daily vitamin supplementation (i.e. 2mg of folic acid, 25mg vitamin B6, and 400 lg of vitamin B12) in 52 patients diagnosed with migraine with aura. Findings Vitamin supplementation reduced homocysteine by 39% (approximately 4 lmol/l) compared with baseline, a reduction that was greater then placebo (P = 0.001). Vitamin supplementation also reduced the prevalence of migraine disability from 60% at baseline to 30% after 6 months (P = 0.01), whereas no reduction was observed for the placebo group (P> 0.1). Headache frequency and pain severity were also reduced (P < 0.05), whereas there was no reduction in the placebo group (P > 0.1). In this patient group the treatment effect on both homocysteine levels and migraine disability was associated with MTHFRC677T genotype whereby carriers of the C allele experienced a greater response compared with TT genotypes (P < 0.05). Interpretation This study provides some early evidence that lowering homocysteine through vitamin supplementation reduces migraine disability in a subgroup of patients. Larger trials are now warranted to establish whether vitamin therapy is a safe, inexpensive and effective prophylactic option for treatment of migraine and whether efficacy is dependant on MTHFRC677T genotype.
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    Journal Title
    Pharmacogenetics and Genomics
    Volume
    19
    DOI
    https://doi.org/10.1097/FPC.0b013e32832af5a3
    Copyright Statement
    © 2009 LWW. This is a non-final version of an article published in final form in Pharmacogenetics and Genomics [Volume, Issue, Page numbers]. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.
    Subject
    Genetics
    Neurology and neuromuscular diseases
    Pharmacology and pharmaceutical sciences
    Publication URI
    http://hdl.handle.net/10072/28411
    Collection
    • Journal articles

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