Serum Homocysteine, Pyridoxine, Folate, and Vitamin B12 Levels in Migraine: Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
Background Migraine, especially migraine with aura (MA), has been linked to increased risk for ischemic cerebrovascular disease. The possible role of elevated serum homocysteine (Hcy, a cause of thrombophilia) in migraine has been demonstrated by several studies. Objective The present study aims to review and meta‐analyze data from studies investigating the difference of serum Hcy and Hcy lowering vitamins between migraine patients and healthy controls (HC), as well as between patients with MA and migraine without aura (MO). Methods Literature search involved MEDLINE, Embase, CENTRAL, Google Scholar, and trial registries. The Newcastle‐Ottawa Scale was used to evaluate the quality of the retrieved studies. Standardized mean differences (SMDs) and 95% confidence intervals (95%CIs) were calculated. Funnel‐plots were utilized for the evaluation of publication bias. Results Overall, 29 (28 case‐control and 1 cross‐sectional) studies were retrieved. Meta‐analysis was indicative of higher Hcy concentration in migraine patients vs HC overall [adults and children: 16 studies, I 2 = 81%, SMD = 0.41, 95%CI = (0.20, 0.61)]. Hcy was consistently elevated in adults with migraine [adults: 12 studies, I 2 = 76%, SMD = 0.35, 95%CI = (0.15, 0.54); children: 1 study, SMD = 0.37, 95%CI = (−0.05, 0.79)]. Subgroup analyses reproduced the results for both adults with MA [7 studies, I 2 = 83%, SMD = 0.37, 95%CI = (0.03, 0.71)] and MO [5 studies, I 2 = 84%, SMD = 0.46, 95%CI = (0.03, 0.89)]. Figures for serum folate were lower in the overall comparison of migraine patients with HC [adults and children: 11 studies, I 2 = 87%, SMD = −0.36, 95%CI = (−0.68, −0.05); adults: 8 studies, I 2 = 6%, SMD = −0.11, 95%CI = (−0.22, 0.01); children: 1 study, SMD = −0.71, 95%CI = (−1.14, −0.29); MA adults: 4 studies, I 2 = 44%, SMD = −0.16, 95%CI = (−0.35, 0.04); MO adults: 4 studies, I 2 = 47%, SMD = −0.17, 95%CI = (−0.44, 0.10)]. Serum vitamin B12 levels were not different between migraine patients and HC [adults and children: 11 studies, I 2 = 88%, SMD = −0.24, 95%CI = (−0.57, 0.09); adults: 8 studies, I 2 = 57%, SMD = −0.10, 95%CI = (−0.28, 0.08); children: 1 study, SMD = 0.29, 95%CI = (−0.13, 0.71); MA adults: 4 studies, I 2 = 63%, SMD = −0.14, 95%CI = (−0.48, 0.20); MO adults: 4 studies, I 2 = 59%, SMD = −0.15, 95%CI = (−0.45, 0.15)]. Serum Hcy was lower in MO than MA [adults and children: 10 studies, I 2 = 39%, SMD = 0.30, 95%CI = (0.14, 0.46), adults: 6 studies, I 2 = 29%, SMD = 0.21, 95%CI = (0.09, 0.36), children: 1 study, SMD = 0.51, 95%CI = (0.22, 0.80)]. Serum folate and vitamin B12 did not differ between MA and MO. Conclusions Our results suggest that there is a possible link between migraine, mainly MA, and elevated serum Hcy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.023 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.028 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".