In Medication‐Overuse Headache, <scp>fMRI</scp> Shows Long‐Lasting Dysfunction in Midbrain Areas

Ferraro, Stefania; Grazzi, Licia; Muffatti, Riccardo; Nava, Simone; Ghielmetti, F.; Bertolino, Nicola; Mandelli, Maria Luisa; Visintin, Eleonora; Bruzzone, Maria Grazia; Nigri, Anna; Epifani, Francesca; Bussone, Gennaro; Chiapparini, Luisa

doi:10.1111/j.1526-4610.2012.02276.x

Cited by 69 publications

(56 citation statements)

References 65 publications

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“…In addition, neuroimaging studies suggest changes in the orbitofrontal cortex and the mesocorticolimbic dopamine circuit [Fumal et al 2006;Ferraro et al 2012]. …”

Section: Pathogenesismentioning

confidence: 99%

Medication-overuse headache: epidemiology, diagnosis and treatment

Kristoffersen

Lundqvist

2014

Therapeutic Advances in Drug Safety

136

100

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Medication-overuse headache (MOH) is one of the most common chronic headache disorders and a public health problem with a worldwide prevalence of 1-2%. It is a condition characterized by chronic headache and overuse of different headache medications, and withdrawal of the overused medication is recognised as the treatment of choice. However, the strategy for achieving withdrawal is, at present, based on expert opinion rather than scientific evidence, partly due to the lack of randomised controlled studies. This narrative review investigates different aspects of epidemiology, diagnosis, risk factors and pathogenesis as well as management for MOH. We suggest that the first step in the treatment of MOH should be carried out in general practice and should focus primarily on detoxification. For most patients, both prevention and follow up after detoxification can also be performed in general practice, thus freeing resources for referral of more complicated cases to headache clinics and neurologists. These suffering patients have much to gain by an earlier treatment-focused approach lower down on the treatment ladder.

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“…In addition, neuroimaging studies suggest changes in the orbitofrontal cortex and the mesocorticolimbic dopamine circuit [Fumal et al 2006;Ferraro et al 2012]. …”

Section: Pathogenesismentioning

confidence: 99%

Medication-overuse headache: epidemiology, diagnosis and treatment

Kristoffersen

Lundqvist

2014

Therapeutic Advances in Drug Safety

136

100

View full text Add to dashboard Cite

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“…What previous literature showed is that, compared to those with episodic migraine, patients with CM have different clinical features, which include problematic lifestyle, MO, genetic, metabolic and physiologic characteristics [5][6][7]. However, once chronification process has developed, there might be different degrees of disease severity, in terms of headaches frequency and type of overused medications.…”

Section: Discussionmentioning

confidence: 92%

“…Approximately, 2 % of general population suffers from CM-MO [2,3], and 2.5 % of migraineurs progress to CM each year [4]. Although the process of chronification has not been completely understood yet, it seems that lifestyle, comorbid conditions, genetic and metabolic factors [5,6], abnormal somatosensory cortex excitability [7] and MO itself [8,9] have a role.…”

Section: Introductionmentioning

confidence: 98%

Approaches to treatments of chronic migraine associated with medication overuse: a comparison between different intensity regimens

Raggi¹,

Schiavolin²,

Leonardi³

et al. 2015

Neurol Sci

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Treatment of chronic migraine with medication overuse requires withdrawal from acute medications. However, guidelines and clear indications for different intensity regimens, i.e., day hospital (DH) vs. inpatient treatment, are not available. Patients completed disability, quality of life (QoL) and depression questionnaires; headaches frequency and overused medications category were collected. Mann-Whitney U test and Chi square were used to assess differences between inpatients and DH patients; Bonferroni correction was applied. 194 patients aged 43.9 ± 12 (160 females) were enrolled (100 from DH, 94 inpatients). Inpatients were older, less educated and with lower employment rates. Inpatients had higher MIDAS scores (P = 0.003) and headache frequency (P = 0.002). They had lower QoL for restrictive (P = 0.002) and preventive components; no difference was found for disability, mood state and QoL emotional component. Patients treated during hospitalization had higher disease severity and lower quality of life, but similar disability and mood state than those treated in DH.

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“…In cocaine, or other drug abusers, dopaminergic neurotransmitters play a very important role in visuospatial attention [55,56]. MOH patients also present dysfunctions in the mesocorticolimbic dopamine-circuit [57], which has been consistently implicated in drug dependence [58]. Furthermore, genetic predisposition to MOH is traced to the polymorphisms of dopamine-related genes [59,60].…”

Section: Discussionmentioning

confidence: 99%

Line bisection in medication-overuse and chronic tension-type headaches

Zhang

Gao

Fan

et al. 2014

Translational Neuroscience

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Background: Both medication-overuse headache (MOH) and drug dependence share similar clinical features and the latter displays some deficits in visuospatial attention. The line bisection performance might help to indicate whether there is also a disruption in the visuospatial attention in MOH. Methods: We administered the line bisection test and measured anxiety and depression levels in 21 patients with MOH, 26 patients with chronic tension-type headaches (CTTH) and in 22 healthy volunteers. Results: On average, MOH patients significantly bisected leftward when referring to both frequency and magnitude, whereas the healthy volunteers and CTTH patients bisected slightly rightward. The levels of anxiety and depression were elevated in both MOH and CTTH patients compared to healthy volunteers, but the anxiety / depression levels were not correlated with the line bisection errors in all participants. Conclusions: We found a pronounced pseudoneglect in MOH, which might indicate a relatively hyperactive right or hypoactive left hemisphere, or both, suggesting the disorder's neuropsychological mechanism might overlap with that of drug dependence.

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In Medication‐Overuse Headache, fMRI Shows Long‐Lasting Dysfunction in Midbrain Areas

Cited by 69 publications

References 65 publications

Medication-overuse headache: epidemiology, diagnosis and treatment

Medication-overuse headache: epidemiology, diagnosis and treatment

Approaches to treatments of chronic migraine associated with medication overuse: a comparison between different intensity regimens

Line bisection in medication-overuse and chronic tension-type headaches

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