Effects of Probiotics on Migraine in Children and Adults: A Systematic Review and Meta-Analysis.
Nadav Gasner, Megan Sweeney, Johanie Victoria Piché et al.
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In 30 seconds
This systematic review and meta-analysis assessed probiotics for migraine prevention in placebo-controlled trials involving adults and children. Seven trials with 612 participants (487 female; 79.6%) were included: five adult and two pediatric studies. Probiotics were associated with a reduction of 2.06 monthly attacks compared with placebo (95% CI - 3.6 to - 0.52). Estimates also favoured probiotics for migraine severity and disability, but their confidence intervals included no effect. The authors graded the evidence as very low certainty and noted that study heterogeneity limits generalizability.
Key findings
- Probiotics reduced monthly migraine attack frequency by - 2.06 (95% CI - 3.6 to - 0.52).
- Migraine severity on a 10-point scale showed a mean difference of - 1.11 (95% CI - 2.26 to 0.03).
- Disability estimates favoured probiotics (standardized mean difference - 0.86; 95% CI - 2.33 to 0.6), with the interval including no effect.
- The review included 7 trials and 612 participants; certainty of evidence was graded very low.
Why it matters
Migraine prevention remains an important clinical goal, and these pooled findings suggest probiotics could be relevant as an adjunct approach. However, the very low certainty and heterogeneity mean the apparent reduction in attack frequency should be interpreted cautiously; the review does not establish a reliable benefit across patient groups or probiotic regimens.
What to keep in mind
Only 7 trials were included, with substantial heterogeneity limiting generalizability; the authors graded the evidence as very low certainty.