Gray matter changes related to medication overuse in patients with chronic migraine

Abstract

Our study showed GMV changes in CMwMO patients compared to the CMwoMO patients. These three cerebral regions accounted for significant variance in analgesics use frequency. Moreover, the GMV of the orbitofrontal cortex was predictive of the response to MO treatments.

Structural Gray Matter Alterations in Chronic Migraine: Implications for a Progressive Disease?

“…One study demonstrated that iron deposition as a possible marker for functional impairment occurs in the periaqueductal gray area in subjects with episodic migraine and chronic daily headache and is positively correlated with duration of the disease. 14 Using DTI, we did not find microstructural white matter changes in chronic migraineurs compared to healthy controls in a previous work. 9 Recently, a VBM study in CM with and without medication overuse found decreased GMV in multiple brain areas including the frontal, temporal and occipital lobes, precuneus and cerebellum.…”

Medication Overuse Headache: Pathophysiological Insights from Structural and Functional Brain MRI Research

“…Lai et al conducted a voxel-based morphometry (VBM) study of chronic migraineurs with medication overuse, chronic migraineurs without medication overuse, and healthy controls. 4 Compared with the chronic migraineurs without medication overuse, those with medication overuse had less gray matter volume in the orbitofrontal cortex and left middle occipital gyrus and greater volume in the left temporal pole/parahippocampus. Furthermore, the gray matter volume of these three regions accounted for 31.1% variance in the frequency of analgesic use after controlling for demographic and clinical variables.…”

“…MOH is associated with gray matter volume abnormalities within brain regions directly associated with pain processing, migraine pathophysiology, and within regions implicated in addiction. Lai et al conducted a voxel‐based morphometry (VBM) study of chronic migraineurs with medication overuse, chronic migraineurs without medication overuse, and healthy controls . Compared with the chronic migraineurs without medication overuse, those with medication overuse had less gray matter volume in the orbitofrontal cortex and left middle occipital gyrus and greater volume in the left temporal pole/parahippocampus.…”

“…In another VBM study of gray matter volume in patients who had chronic migraine with medication overuse, 19 of 33 patients had at least a 50% reduction in headache frequency or analgesic use at 12 months follow‐up . After correcting for age, anxiety and depression, greater orbitofrontal volume was significantly associated with this good outcome at 12 months.…”

Migraine: What Imaging Reveals

“…Many imaging studies to date have demonstrated altered brain structure and function in prefrontal areas of migraine patients [25,31,36,66,67] in regions associated with cognitive aspects of pain processing. Similarly, a number of recent rs-fc MRI studies have indicated abnormal fc within the salience network, a core resting-state network that includes paralimbic-limbic regions believed to play a role in the detection of stimuli and the allocation of attentional resources.…”