The Role of Gut Microbiota in Migraine: Effects of Probiotics, Prebiotics, and Their Combinations

Migraine, a common neurological disorder affecting about 15% of the global population, severely impacts quality of life and poses a significant economic burden. While the exact causes of migraine remain unclear, factors like oxidative stress, neurogenic inflammation, mitochondrial dysfunction, and gut dysbiosis are implicated. Through the gut-brain axis, the gut microbiota appears to play a key role in migraine pathophysiology. Patients with migraine often exhibit gastrointestinal comorbidities, and experimental studies indicate that dysbiosis can worsen migraine-like pain by amplifying inflammation and disrupting gut barrier integrity. This narrative review aims to assess the effects of probiotics, prebiotics, and synbiotics on migraine attack frequency and severity, focusing on their role in modulating gut microbiota. Evidence suggests probiotics may reduce migraine frequency and severity by enhancing gut barrier function and regulating inflammation. Prebiotics, through the improvement of gut eubiosis, may also help alleviate symptoms. However, the effects of probiotics are strain and dose dependent, leading to inconsistent findings. Studies on prebiotics and synbiotics are limited but indicate potential benefits in reducing migraine symptoms. Despite promising findings, the current literature presents mixed results regarding the effectiveness of probiotics on migraine, highlighting the importance of strain specificity and dosage. The limited number of studies on prebiotics and synbiotics, along with the variability in study designs, strains, dosages, and patient populations, complicates the ability to draw definitive conclusions. Further well-designed clinical trials are needed to elucidate the role of gut microbiota interventions in migraine management and to determine the optimal conditions for their therapeutic use.