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Grey matter changes associated with medication-overuse headache: correlations with disease related disability and

Franz Riederer1, Marvin Marti, Roger Luechinger

  • 1Department of Neurology, Headache Unit, University Hospital Zurich, Zurich, Switzerland.

The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry
|July 4, 2012
PubMed
Abstract

Insights

Medication-overuse headache (MOH) is linked to psychiatric issues. Brain imaging reveals altered grey matter in pain and reward circuits, potentially explaining dependence in some patients.

Area of Science:

  • Neuroimaging
  • Neurology
  • Psychiatry

Background:

  • Medication-overuse headache (MOH) frequently co-occurs with psychiatric conditions.
  • Similarities between MOH and substance dependence suggest shared neurobiological underpinnings.
  • Investigating structural brain changes in MOH is crucial for understanding its pathophysiology.

Purpose of the Study:

  • To examine grey matter volume differences in patients with MOH and migraine.
  • To explore the relationship between grey matter changes and psychiatric comorbidities.
  • To investigate the role of pain and reward systems in MOH.

Main Methods:

  • Voxel-based morphometry was used to analyze structural MRI scans.
  • 29 patients with MOH and migraine were compared to healthy controls.
  • Psychiatric status was assessed using standardized questionnaires and clinical interviews.

Main Results:

  • Increased grey matter volume (GMV) was observed in the midbrain periaqueductal grey, thalamus, and ventral striatum.
  • GMV increases correlated with headache disability and anxiety levels.
  • Decreased GMV was found in frontal regions, including the orbitofrontal cortex and insula.

Conclusions:

  • Findings suggest impaired antinociceptive system function in MOH, modulated by anxiety.
  • Altered reward system function may underlie dependence in a subset of MOH patients.
  • Structural brain changes offer insights into the neurobiology of MOH and its psychiatric links.

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