Mufeed TAHA, Mohammed ABDULWAHHAB, Ahmed MOSTAFA

Epizodik Migrende Koenzim Q10'un Profilaktik Tedavi Olarak Etkisi

Amaç: Migren, tekrarlayan ve sıklıkla şiddetli baş ağrılarıyla karakterize bir nörolojik hastalıktır. Bu çalışmanın amacı, epizodik migren profilaksisinde koenzim Q10'un (CoQ10) etkinliğini değerlendirmektir. Gereç ve Yöntemler: Prospektif bir takip çalışmasında, epizodik migreni olan 80 hasta Başağrısı Bozukluklarının Uluslararası Sınıflaması 3. basımına göre çalışmaya dahil edildi ve iki gruba ayrıldı. Bir grup, üç ay boyunca monoterapi olarak günde iki kez oral 200 mg CoQ10 alan 40 hastadan oluşurken, diğer grup ise diğer profilaktik antimigren ilaçlarla birlikte yardımcı tedavi olarak CoQ10 alan 40 hastadan oluşuyordu. Her iki gruba da tedaviden önce ve üç aylık tedaviden sonra Migren Dizabilite Değerlendirme (Migraine Disability Assessment, MIDAS) anketi uygulandı. Üç aylık tedavi periyodu boyunca, hastaların günlük semptomları kaydetmesiyle, başlangıçtan itibaren semptom şiddeti, atak sayısı ve süresindeki değişikliklerin gözlemlenmesine olanak sağlandı. Bulgular: CoQ10 takviyesi alan her iki grup da olumlu yanıtlar gösterdi. Ek tedavi alan grup, monoterapi grubuna göre MIDAS’ta (p<0,001), atak süresi (p<0,001) ve sıklığında (p<0,001) istatistiksel olarak daha belirgin bir azalma gösterdi. Ek tedavi grubunda kusma (p<0,001) tamamen kayboldu ve ses duyarlılığı (p=0,002) tedaviye dramatik bir yanıt gösterdi. Sonuç: CoQ10 Iraklı epizodik migren hastalarında monoterapiye göre sadece yardımcı tedaviye yanıt veren ses duyarlılığına ek olarak süreyi, sıklığı ve bulantı, kusma ve ışığa duyarlılık gibi semptomların ortaya çıkışını azaltmada yardımcı olarak monoterapiden daha yararlı etkilere sahip gibi görünmektedir.

Anahtar Kelimeler:

Migren bozuklukları, Koenzim Q10, profilaksi

The Effect of Coenzyme Q10 as a Prophylactic Treatment in Episodic Migraine

Aim: Migraine is a neurological disorder characterized by recurring and often severe headaches. The aim of this study was to evaluate the effectiveness of coenzyme Q10 (CoQ10) in episodic migraine prophylaxis. Material and Methods: In a prospective follow-up study, 80 patients with episodic migraine were enrolled according to the International Classification of Headache Disorders 3rd edition and divided into two groups. One group consisted of 40 patients who received CoQ10 oral 200 mg twice daily as monotherapy for three months, while the other group consisted of 40 patients who received CoQ10 as an adjunct therapy in combination with other prophylactic antimigraine drugs. The Migraine Disability Assessment (MIDAS) questionnaire was administered to both groups before and after three months of therapy. Throughout the three-month therapy period, patients recorded daily symptoms, allowing for observation of changes in symptom severity, number, and duration of attacks from baseline. Results: Both groups that received CoQ10 supplementation exhibited positive responses. The group receiving adjunct therapy showed a statistically more significant reduction in the MIDAS (p<0.001), duration (p<0.001), and frequency (p<0.001) of attacks compared to the monotherapy group. Vomiting (p<0.001) in the adjunct therapy group completely disappeared and sound sensitivity (p=0.002) showed a dramatic response to treatment. Conclusion: CoQ10 appears to have more beneficial effects as an adjunct than monotherapy in reducing the duration, frequency, and presenting symptoms such as nausea, vomiting, and light sensitivity, in addition to sound sensitivity that responded only to adjunct therapy than monotherapy among Iraqi patients with episodic migraine.

Keywords:

Migraine disorders, Coenzyme Q10, prophylaxis,

PDF

___

Iba C, Ohtani S, Lee MJ, Huh S, Watanabe N, Nakahara J, et al. Migraine triggers in Asian countries: a narrative review. Front Neurol. 2023;14:1169795.
Ashina M, Katsarava Z, Do TP, Buse DC, Pozo-Rosich P, Özge A, et al. Migraine: epidemiology and systems of care. Lancet. 2021;397(10283):1485-95.
Hajihashemi P, Askari G, Khorvash F, Reza Maracy M, Nourian M. The effects of concurrent Coenzyme Q10, L-carnitine supplementation in migraine prophylaxis: A randomized, placebo-controlled, double-blind trial. Cephalalgia. 2019;39(5):648-54.
Ashina M, Tvedskov J, Lipka K, Bilello J, Penkowa M, Olesen J. Matrix metalloproteinases during and outside of migraine attacks without aura. Cephalalgia. 2010;30(3):303-10.
Borkum JM. Brain energy deficit as a source of oxidative stress in migraine: a molecular basis for migraine susceptibility. Neurochem Res. 2021;46(8):1913-32.
Yaghini O, Hoseini N, Ghazavi MR, Mansouri V, Nasiri J, Moosavian T, et al. A comparative study on the efficacy of coenzyme Q10 and amitriptyline in the prophylactic treatment of migraine headaches in children: A randomized controlled trial. Adv Biomed Res. 2022;11:43.
Hoffman W, Luster JD, Izurieta R. A concise review of coenzyme q10 supplementation in the preventative treatment of migraine. J Med Case Rep Rev. 2020;3(8):717-24.
Vikelis M, Dermitzakis EV, Vlachos GS, Soldatos P, Spingos KC, Litsardopoulos P, et al. Open label prospective experience of supplementation with a fixed combination of magnesium, vitamin B2, feverfew, Andrographis paniculata and coenzyme Q10 for episodic migraine prophylaxis. J Clin Med. 2020;10(1):67.
Sazali S, Badrin S, Norhayati MN, Idris NS. Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine-a meta-analysis. BMJ Open. 2021;11(1):e039358.
Zhu B, Coppola G, Shoaran M. Migraine classification using somatosensory evoked potentials. Cephalalgia. 2019;39(9):1143-55.
Ducros A, de Gaalon S, Roos C, Donnet A, Giraud P, Guégan-Massardier E, et al. Revised guidelines of the French headache society for the diagnosis and management of migraine in adults. Part 2: Pharmacological treatment. Rev Neurol (Paris). 2021;177(7):734-52.
Esmael ZF, Hamdan FB. Blink reflex study in patients with migraine. Iraqi J Med Sci. 2022;20(2):175-82.
Iannone LF, Fattori D, Benemei S, Chiarugi A, Geppetti P, De Cesaris F. Long-term effectiveness of three anti-CGRP monoclonal antibodies in resistant chronic migraine patients based on the MIDAS score. CNS drugs. 2022;36(2):191-202.
Mustafa WW, Mohammed SS, Naser ZA. Migraine headache and gender differences of Bagdad city population/Iraq. Indian J Forensic Med Toxicol. 2021;15(1):1787-92.
Almohammadawi KOM, Alhilfi HSQ, Alkhalidy RAA. Clinical characteristics of migraine: A prospective cross-sectional study over nine years. F1000Research. 2018;7:1973.
Ofovwe GE, Ofili AN. Prevalence and impact of headache and migraine among secondary school students in Nigeria. Headache. 2010;50(10):1570-5.
Güneş M, Özeren E. Effectiveness of bilateral greater and lesser occipital nerve blocks in the prophylaxis of episodic migraine. Duzce Med J. 2021;23(1):93-6.
Androulakis XM, Sen S, Kodumuri N, Zhang T, Grego J, Rosamond W, et al. Migraine age of onset and association with ischemic stroke in late life: 20 years follow‐up in ARIC. Headache. 2019;59(4):556-66.
Nattagh-Eshtivani E, Dahri M, Hashemilar M, Tarighat-Esfanjani A. The effect of coenzyme Q10 supplementation on serum levels of lactate, pyruvate, matrix metalloproteinase 9 and nitric oxide in women with migraine. A double blind, placebo, controlled randomized clinical trial. Eur J Integr Med. 2018;21:70-6.
Hendrix C. Migraine-prophylactic and acute migraine treatments. Evidence-Based Use of Supplements. 2021;4.
Parohan M, Sarraf P, Javanbakht MH, Ranji-Burachaloo S, Djalali M. Effect of coenzyme Q10 supplementation on clinical features of migraine: A systematic review and dose-response meta-analysis of randomized controlled trials. Nutr Neurosci. 2020;23(11):868-75.
Yang W, Chu B, Yang J, Yu Y, Wu J, Yu S. Elevated audiovisual temporal interaction in patients with migraine without aura. J Headache Pain. 2014;15(1):44.
Kalita J, Misra UK, Bansal R. Phonophobia and brainstem excitability in migraine. Eur J Neurosci. 2021;53(6):1988-97.
Guilbot A, Bangratz M, Ait Abdellah S, Lucas C. A combination of coenzyme Q10, feverfew and magnesium for migraine prophylaxis: a prospective observational study. BMC Complement Altern Med. 2017;17(1):433.
Gross EC, Lisicki M, Fischer D, Sándor PS, Schoenen J. The metabolic face of migraine-from pathophysiology to treatment. Nat Rev Neurol. 2019;15(11):627-43.
Yaghini O, Hoseini N, Ghazavi MR, Mansouri V, Nasiri J, Moosavian T, et al. A comparative study on the efficacy of coenzyme Q10 and amitriptyline in the prophylactic treatment of migraine headaches in children: A randomized controlled trial. Adv Biomed Res. 2022;11:43.