Brain structural investigation and hippocampal tractography in medication overuse headache: a native space analysis

Abstract

BackgroundSpatial normalization of brain images, a prerequisite for voxel based morphometry analysis, may account for the large variability of the volumetric data in medication overuse headache (MOH); possibly because this disease concerns patients differing on both sex and age, and hence with different brain size and shape.MethodsThe present study aimed at providing a subject-based analysis of macrostructure using a native space volumes segmentation (Freesurfer), and microstructure using a region of interest (ROI: i.e. hippocampus) tractography approach in MOH patients.ResultsThe results show that MOH patients had decreased volumes of left hemisphere temporal gyri (temporal superior, fusiform) and occipital middle gyrus, together with an increased volume of the left inferior (temporal) lateral ventricle. The left temporal volume was negatively correlated with depression score and medication dependence parameters. Seed-based tractography of the hippocampus revealed a decreased number of reconstructed fibers passing through the left hippocampus.ConclusionTo our knowledge, these alterations have not been described with methods involving brain normalization, and they indicate that left hemisphere temporal areas, including the hippocampus, may play a role in MOH pathophysiology. Trial registration number NCT00833209. Registered 29 January 2009

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“…Furthermore, the volume of the periaqueductal grey matter of the midbrain was also significantly increased in these patients, which was positively correlated with more migrainerelated disability and higher levels of anxiety. An increase in GMV was also found bilaterally in the thalamus and ventral striatum, while a significant decrease was detected in the frontal regions including the orbitofrontal cortex, anterior cingulate cortex, left and right insula, and precuneus [57][58][59].…”

“…In another study on MOH patients, it was found that the volumes of the superior temporal, fusiform, and occipital middle gyrus of the left hemisphere were decreased while the volume of the left inferior temporal/lateral ventricle and middle frontal sulcus were increased. The left temporal superior gyrus volume was negatively correlated with depression scores, number of medications taken per month, and medication dependence scores [57].…”