Cortical Alterations in Medication‐Overuse Headache

Riederer, Franz; Schaer, Marie; Gantenbein, Andreas R.; Luechinger, Roger; Michels, Lars; Kaya, Marihan; Kollias, Spyridon; Sándor, Péter

doi:10.1111/head.12993

Cited by 20 publications

(21 citation statements)

References 55 publications

(108 reference statements)

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“…Consistent with functional data, results of structural imaging reveal abnormalities within major regions of the mesocortical-limbic circuit in patients with MOH, including less orbitofrontal cortex volume and thickness (23,24,26). Results of several studies suggest that patients with better treatment response to medication withdrawal had more orbitofrontal volume at baseline, i.e., before withdrawal compared to patients who did not respond successfully to medication withdrawal (23,25).…”

Section: Brain Structure and The Orbitofrontal Cortexsupporting

confidence: 55%

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Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Chong

2020

Front. Neurol.

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This chapter overviews research neuroimaging findings of patients with medication-overuse headache (MOH). Results indicate; (i) correlations between neuropathology and medication-overuse; (ii) changes in brain morphology and cortical function; and (iii) brain recovery subsequent to withdrawal of medication that was overused. Results of this narrative review indicate exacerbated brain structural and functional changes in regions of the pain-matrix and in regions of the mesocortical-limbic circuit in patients with MOH compared to patients with migraine or compared to healthy controls. Modification of brain morphology as well as an association between brain recovery and medication withdrawal suggest that the MOH disease process involves state (brain modification) and trait-like (brain adaptation and recovery) neuromechanisms.

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Section: Brain Structure and The Orbitofrontal Cortexsupporting

confidence: 55%

“…Compared to healthy controls, Riederer et al (26) found higher cortical gyrification over the temporal and occipital cortex in MOH (but not over the orbitofrontal cortex). In addition, patients with higher occipital pole gyrification had poorer response to medication withdrawal.…”

Section: Brain Structure and The Orbitofrontal Cortexmentioning

confidence: 97%

Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Chong

2020

Front. Neurol.

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“…Taken together, the results of these studies and our study indicate that the number and the severity of post‐traumatic symptoms are associated with brain integrity in frontal and parietal areas. Furthermore, morphological abnormalities in several of these brain regions have previously been demonstrated in pain conditions including chronic back pain, migraine, fibromyalgia, and medication‐overuse headache . Therefore, further investigation is required to determine if the findings of our study are specific for PPTH or if they are generalizable to other chronic pain conditions and other symptoms that occur following concussion.…”

Section: Discussionmentioning

confidence: 82%

“…Furthermore, morphological abnormalities in several of these brain regions have previously been demonstrated in pain conditions including chronic back pain, migraine, fibromyalgia, and medication-overuse headache. [37][38][39][40] Therefore, further investigation is required to determine if the findings of our study are specific for PPTH or if they are generalizable to other chronic pain conditions and other symptoms that occur following concussion.…”

Section: Discussionmentioning

confidence: 99%

Less Cortical Thickness in Patients With Persistent Post‐Traumatic Headache Compared With Healthy Controls: An MRI Study

et al. 2017

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Objective.-To investigate differences in cortical thickness in patients with persistent post-traumatic headache (PPTH) relative to healthy controls and to interrogate whether cortical morphology relates to headache burden (headache frequency, years with post-traumatic headache, PTH) in patients with PPTH.Background.-PTHs are one of the most common symptoms following concussion. In some patients, PTHs continue for longer than three months and are classified as PPTH. This study has two main goals: (1) To delineate the neuropathology of PPTH, by interrogating differences in cortical thickness in patients with PPTH relative to healthy controls. (2) To interrogate potential associations between brain morphology and headache burden in patients with PPTH by examining whether cortical thickness relates to frequency of headaches or years lived with PTH.Methods.-Adults with PPTH diagnosed according to ICHD 3 beta diagnostic criteria and healthy controls underwent brain MRI on a 3 Tesla scanner. Vertex-by-vertex whole brain estimates of cortical thickness were automatically calculated using FreeSurfer v5.3. Differences in cortical thickness in patients with PPTH relative to healthy controls were determined using a general linear model design. Associations were explored between regional clusters where patients with PPTH showed cortical thickness differences compared with healthy controls with headache frequency and years lived with PPTH.Results.-This study included 33 patients with PPTH and 33 healthy control subjects (healthy controls: median age 5 33.0, IQR 5 15.5; patients with PPTH: median age 5 36.0, IQR 5 20.5; P 5 .56). Patients with PPTH had less cortical thickness relative to healthy controls in the left and right superior frontal, caudal middle frontal, and precentral cortex as well as less cortical thickness in the right supramarginal, right superior and inferior parietal, and right precuneus region (P < .05, Monte Carlo corrected for multiple comparisons). There were no regions where patients with PPTH had more cortical thickness relative to healthy controls. A correlation analysis of regions that showed less cortical thickness in patients with PPTH demonstrated a negative correlation between left and right superior frontal thickness with headache frequency (P < .05). There was no association between regional cortical thickness and years lived with PPTH.Conclusion.-Compared with healthy controls, patients with PPTH had less cortical thickness in bilateral frontal regions and right hemisphere parietal regions. For patients with PPTH, more frequent headaches were related to less thickness in the left and right superior frontal regions, potentially indicating that brain morphology changes in the superior frontal regions in patients with PPTH are modified by headache frequency.

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“…Previous voxel-based morphometry (VBM) 12 or surface-based morphometry 15 studies analyzed gray matter volume (GMV) or cortical thickness based on clusters but whether the more macroscopic volume of brain regions altered was unknown. Other volume studies adopted focal region of interest 11 and could not reflect the more widespread volume alteration over the whole brain.…”

Section: Discussionmentioning

confidence: 99%

Morphometric changes over the whole brain in caffeine-containing combination-analgesic-overuse headache

Chen

Dong

et al. 2018

Mol Pain

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ObjectiveTo investigate brain morphometric changes in medication-overuse headache with excessive intake of caffeine-containing combination analgesics.Materials and methodsWe recruited 32 medication-overuse headache patients overusing caffeine-containing combination analgesics and 26 normal controls with matched sex and age. Magnetic resonance T1-weighted images were processed by automatic volume algorithm of brain regions over the whole brain according to the neuromorphometrics template. We explored the volume differences between groups and correlation with clinical variables.ResultsMedication-overuse headache patients demonstrated decreased volume in cerebellum, optic chiasm, and increased volume in right lateral orbital gyrus, left calcarine, bilateral middle occipital gyrus, right superior parietal lobe, and right temporal transverse gyrus compared with normal controls. The increased volume was primarily contributed by patients of lower headache frequency (10–20 days/month) and with no psychological comorbidities. In regression analyses, the volume of bilateral middle occipital gyrus had negative association with migraine duration, and the volume of right lateral orbital gyrus and right superior parietal lobe was negatively correlated with number of medications per month.ConclusionsVolume changes of brain regions involved in affective and cognitive processing, visual and auditory perception, and pain sensory/discrimination suggested a particular role of those regions in the pathogenesis of medication-overuse headache overusing caffeine-containing combination analgesics. Morphometric changes in multiple visual processing areas and volume gain in lower headache frequency and less anxiety and depression may be specific features related to overusing caffeine-containing combination analgesics.

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Cortical Alterations in Medication‐Overuse Headache

Abstract: Corroborating previous volumetric results, our study adds information on the putative neurobiological mechanisms involved in MOH, suggesting neurodevelopmental changes in MOH.

Cited by 20 publications

References 55 publications

Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Less Cortical Thickness in Patients With Persistent Post‐Traumatic Headache Compared With Healthy Controls: An MRI Study

Morphometric changes over the whole brain in caffeine-containing combination-analgesic-overuse headache

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