Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Chong, Catherine D.

doi:10.3389/fneur.2019.01336

Cited by 6 publications

(6 citation statements)

References 38 publications

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“…Taken together, these results reflect functional and morphological reorganization of subcortical and cortical structures due to central sensitization and dysfunctioning central pain control mechanisms in CM-MOH patients (32,40,41).…”

Section: Discussionmentioning

confidence: 57%

Central sensitization mechanisms in chronic migraine with medication overuse headache: a study of thalamocortical activation and lateral cortical inhibition

Sebastianelli,

Casillo,

Abagnale

et al. 2023

Cephalalgia

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Background It is unclear whether cortical hyperexcitability in chronic migraine with medication overuse headache (CM-MOH) is due to increased thalamocortical drive or aberrant cortical inhibitory mechanisms. Methods Somatosensory evoked potentials (SSEP) were performed by electrical stimulation of the median nerve (M), ulnar nerve (U) and simultaneous stimulation of both nerves (MU) in 27 patients with CM-MOH and, for comparison, in 23 healthy volunteers (HVs) of a comparable age distribution. We calculated the degree of cortical lateral inhibition using the formula: 100 – [MU/(M + U) × 100] and the level of thalamocortical activation by analyzing the high frequency oscillations (HFOs) embedded in parietal N20 median SSEPs. Results Compared to HV, CM-MOH patients showed higher lateral inhibition (CM-MOH 52.2% ± 15.4 vs. HV 40.4% ± 13.3; p = 0.005), which positively correlated with monthly headache days, and greater amplitude of pre-synaptic HFOs ( p = 0.010) but normal post-synaptic HFOs ( p = 0.122). Conclusion Our findings suggest that central neuronal circuits are highly sensitized in CM-MOH patients, at both thalamocortical and cortical levels. The observed changes could be due to the combination of dysfunctional central pain control mechanisms, hypersensitivity and hyperresponsiveness directly linked to the chronic intake of acute migraine drugs.

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Section: Discussionmentioning

confidence: 57%

Central sensitization mechanisms in chronic migraine with medication overuse headache: a study of thalamocortical activation and lateral cortical inhibition

Sebastianelli,

Casillo,

Abagnale

et al. 2023

Cephalalgia

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“…Interestingly, after medication withdrawal, other regional metabolic changes were found to normalize in this study, with the exception of continued hypometabolism in the orbitofrontal region (Fumal et al, 2006 ), which might be related to the fact that the orbitofrontal cortex plays a role in addictive disorders. Moreover, the results of structural imaging studies have revealed abnormalities, including lower orbitofrontal cortex volume and thickness (Chong, 2019 ). Therefore, the decreased NVC in ORBsup.L observed in the current study is consistent with the abovementioned previous functional and structural studies, which could be used to explain MOH pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Altered cerebral neurovascular coupling in medication-overuse headache: A study combining multi-modal resting-state fMRI with 3D PCASL

Liu

Fan

et al. 2023

Front. Neurosci.

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AimStructural and functional changes in the brain have been identified in individuals with medication-overuse headache (MOH) using MRI. However, it has not been clearly established whether neurovascular dysfunction occurs in MOH, which could be elucidated by examining neurovascular coupling (NVC) from the viewpoints of neuronal activity and cerebral blood flow. The aim of this study was to investigate potential alterations in NVC function of the brain in individuals with MOH using resting-state functional MRI (rs-fMRI) and 3D pseudo-continuous arterial spin labeling (3D PCASL) imaging techniques.MethodsA total of 40 patients with MOH and 32 normal controls (NCs) were recruited, and rs-fMRI and 3D PCASL data were obtained using a 3.0 T MR scanner. Standard preprocessing of the rs-fMRI data was performed to generate images representing regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuation (fALFF), and degree centrality (DC); cerebral blood flow (CBF) images were generated using 3D PCASL sequence data. These functional maps were all normalized into Montreal Neurological Institute (MNI) space, and NVC was subsequently determined on the basis of Pearson correlation coefficients between the rs-fMRI maps (ReHo, fALFF, and DC) and CBF maps. The statistical significance of differences between the MOH and NC groups in terms of NVC in different brain regions was established via Z-test. Further analysis was performed to examine correlations between NVC in the brain regions with NVC dysfunction and clinical variables among patients with MOH.ResultsNVC mainly presented a negative correlation in patients with MOH and NCs. No significant difference between the two groups was detected in terms of average NVC over the entire gray matter area. However, several brain regions with significantly decreased NVC in patients with MOH compared to NCs were identified: the left orbital region of the superior frontal gyrus, the bilateral gyrus rectus, and the olfactory cortex (P < 0.05). A correlation analysis revealed that the DC of the brain regions with NVC dysfunction was significantly positively correlated with disease duration (r = 0.323, P = 0.042), and DC–CBF connectivity was negatively correlated with VAS score (r = −0.424, P = 0.035).ConclusionThe current study demonstrated that cerebral NVC dysfunction occurs in patients with MOH, and the NVC technique could function as a new imaging biomarker in headache research.

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“…Another study of the functional characteristics of the brain in CM − MOH during the interictal phase, using static functional connectivity and static and dynamic functional network connectivity analyses, found that the abnormal connectivity pattern between sensory and cognitive brain networks and altered connectivity were concentrated in the executive control network of the CM patients [50]. Compared to patients with a migraine, patients with MOH exhibit exacerbated changes in brain structure and function in regions of the pain matrix and areas of the mesocortical-limbic circuit [51].…”

Section: Discussionmentioning

confidence: 99%

Differences in Frontal Lobe Dysfunction in Patients with Episodic and Chronic Migraine

Lee

Song

et al. 2021

JCM

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Neuroimaging and neuropsychological investigations have indicated that migraineurs exhibit frontal lobe-related cognitive impairment. We investigated whether orbitofrontal and dorsolateral functioning differed between individuals with episodic migraine (EM) and chronic migraine (CM), focusing on orbitofrontal dysfunction because it is implicated in migraine chronification and medication overuse headache (MOH) in migraineurs. This cross-sectional study recruited women with CM with/without MOH (CM + MOH, CM − MOH), EM, and control participants who were matched in terms of age and education. We conducted neuropsychological assessments of frontal lobe function via the Trail Making Test (TMT) A and B, the Wisconsin Card Sorting Test (WCST), and the Iowa Gambling Task (IGT). We enrolled 36 CM (19 CM + MOH, 17 CM–MOH), 30 EM, and 30 control participants. The CM patients performed significantly (p < 0.01) worse on the TMT A and B than the EM patients and the control participants. The WCST also revealed significant differences, with poorer performance in the CM patients versus the EM patients and the control participants. However, the net scores on the IGT did not significantly differ among the three groups. Our findings suggest that the CM patients exhibited frontal lobe dysfunction, and, particularly, dorsolateral dysfunction. However, we found no differences in frontal lobe function according to the presence or absence of MOH.

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Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Cited by 6 publications

References 38 publications

Central sensitization mechanisms in chronic migraine with medication overuse headache: a study of thalamocortical activation and lateral cortical inhibition

Central sensitization mechanisms in chronic migraine with medication overuse headache: a study of thalamocortical activation and lateral cortical inhibition

Altered cerebral neurovascular coupling in medication-overuse headache: A study combining multi-modal resting-state fMRI with 3D PCASL

Differences in Frontal Lobe Dysfunction in Patients with Episodic and Chronic Migraine

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