The effect of an epigenetic diet on migraine patients

Migraine is a common type of primary headache disorder, distinguished by recurrent attacks of moderate to severe unilateral throbbing pain, often accompanied by symptoms such as nausea, photophobia, and phonophobia. 
Objective — to study the effect of epigenetic diet on frequency and intensity of migraine headache attacks, indicators of psycho‑emotional status and quality of life of migraine patients. 
Methods and subjects. 130 people aged from 18 to 55 years (average age — 38.6 ± 8.3 years) were examined, of which 15 (11.5 %) were men and 115 (88.4 %) were women. The patients were distributed into two groups: group A — patients who followed an epigenetic diet enriched with 5 mg of folic acid, group B — patients who did not follow any diet. The diagnosis of migraine was confirmed using the criteria of the International Headache Society. Before the study, all participants were assessed using the Work Disability Assessment Scale (MIDAS). Also, the frequency of headache was determined in all patients. Headache intensity was assessed using a visual analog scale (VAS). Psychoemotional status at the beginning and at the end of the study was assessed using the Hamilton Anxiety Scale and the Beck Depression Scale. In all patients, the content of folic acid and homocysteine in the blood was determined using an immunochemical method with electrochemiluminescence detection. 
Results. When analyzing the data before the start of the study, it was found that the average concentration of folic acid in group A was 2.8 ± 3.6 ng/ml and was significantly lower than in group B (p = 0.003). The average level of homocysteine was different in both groups (р = 0.04). In group A, against the background of using an epigenetic diet, the average level of folic acid remarkably increased (p = 0.001), and the average level of homocysteine significantly decreased (p = 0.003). Also, in group A, a notable decrease in the intensity and frequency of headache was found (р = 0.02; р = 0.04), a decrease in the average level of anxiety according to the Hamilton scale (from 15.0 ± 3.5 points to 9 ± 2 points) (p = 0.03). A direct relationship between the level of homocysteine and the score on the Hamilton Anxiety Scale and the MIDAS scale was established, as well as a negative correlation between the level of folic acid and the score on the Beck Depression Scale. 
Conclusions. Evidence of the influence of changes in the content of homocysteine and folic acid in the blood of patients with migraine against the background of an epigenetic diet on the severity of headache and quality of life was revealed. The use of an epigenetic diet in the prevention and treatment of migraine needs further study, as it is difficult to predict the final effect of the diet due to its low specificity to the epigenome and the large number of interactions between the active components of the diet. 
 