ORIGINAL ARTICLE The serum level of inflammatory markers in chronic and episodic migraine: a case-control study Fahimeh Martami 1,2 & Soodeh Razeghi Jahromi 1,2 & Mansoureh Togha 1 & Zeinab Ghorbani 1,3 & Maryam Seifishahpar 1,2 & Atoosa Saidpour 2 Received: 17 April 2018 /Accepted: 5 July 2018 # Springer-Verlag Italia S.r.l., part of Springer Nature 2018 Abstract The exact mechanism of the migraine pathophysiology remained unclear. Although there are some reports showing low-grade inflammation in migraineurs, further studies are needed in this field. Thus, we designed a study to evaluate the serum levels of two main proinflammatory markers in migraine patients. In this case-control research, 43 migraine patients (23 chronic and 20 episodic migraineurs) and 40 age-sex-matched headache-free controls were studied. Demographic, dietary, and anthropometric data, headache characteristics, and serum C-reactive proteins (CRP) and tumor necrosis factor-alpha (TNF-α) assessments were collected. The mean ± SD age of the case and control groups were 36.98 ± 9.91 and 34.84 ± 9.75 years respectively. Compared to control subjects, both episodic and chronic migraineurs had significantly higher median levels of TNF-α (0.24, 0.95, and 1.90 pg/ ml, respectively; P value < 0.001). Also, we observed a positive association between the TNF-α levels and the odds of having migraine after considering gender, age, body mass index, and dietary intakes of energy, carbohydrate, protein, fat, and mono and poly unsaturated fatty acids in the multivariable regression models (OR = 2.15; 95% CI 1.31–3.52; P value < 0.001). However, no significant association was demonstrated between migraine and serum CRP (OR = 2.91; 95% CI 0.87–9.78; P value = 0.08). These findings supported that inflammatory state could be related to the pathogenesis of migraine and it can thus be suggested that this effect might be beyond migraine progression. Further detailed studies are needed to investigate the importance of these findings in the pathogenesis of migraine headache. Keywords C-reactive proteins (CRP) . Headache . Inflammation . Migraine . Tumor necrosis factor-alpha (TNF-α) Introduction Migraine is one of the most disabling neurological disease with symptoms that include recurrent, moderate to severe headache attack, nausea, vomiting, photo- and/or phonophobia [1]. Migraine affects approximately 11% of the adult population worldwide [2] and it is three times more prevalent in females than in males [3]. This condition is associated with high indi- vidual and society burden and is listed as the third highest cause of disability in under 50 years old [4]. Based on frequency of headache attacks, migraine sub-classified into chronic migraine (CM) and episodic migraine (EM) [5]. EM (defined as less than 15 days of headache per month) is more prevalent than CM [6] and, if it is not paid proper attention to EM, it progresses to CM over time [7]. Patients who suffer from CM experience more than 14 days of headache per month and have higher headache- related disability compare to EM [8]. Migraine as a complex disorder is more than a simple head- ache. So far, many underlying mechanisms and factors, in- cluding obesity, vascular, neurogenic, and trigeminovascular system activation have been hypothesized. It is now almost established that some immunological changes could contrib- ute to migraine. Recent insights have focused on Bneurogenic inflammation^ theory that emphasizes on the release of Fahimeh Martami and Maryam Seifishahpar contributed equally to this work. * Mansoureh Togha Toghae@sina.tums.ac.ir 1 Headache Department, Iranian Center of Neurological Research¸ Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran 2 Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Neurological Sciences https://doi.org/10.1007/s10072-018-3493-0