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Gray matter alteration in medication overuse headache: a coordinates-based activation likelihood estimation
Wenjia Chen1,2, Hui Li3,4, Xiaoyan Hou5
1Headache Sub-department of Neurology Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chines Medicine, Guangzhou, People's Republic of China.
Brain Imaging and Behavior
|February 10, 2022
Summary
Medication overuse headache (MOH) is linked to significant gray matter changes in brain regions associated with reward and pain processing. These alterations may be reversible upon discontinuing analgesic use.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Medication overuse headache (MOH) is a prevalent secondary headache disorder with substantial economic and neuropsychological impact.
- Previous neuroimaging studies on MOH have yielded inconsistent findings, necessitating a comprehensive analysis.
Approach:
- A meta-analytic activation likelihood estimation (ALE) was employed to synthesize findings from morphological neuroimaging studies.
- Five voxel-based morphometry (VBM) studies, encompassing 344 subjects and 54 coordinates, were included to identify consistent gray matter alterations in MOH patients.
Key Points:
- MOH patients exhibited increased gray matter density in the midbrain, striatum, cingulate, inferior parietal cortex, and cerebellum compared to healthy controls.
- Decreased gray matter density was observed in the orbitofrontal cortex, frontal, insular, and parietal cortices.
- Analgesic withdrawal was associated with reduced gray matter density in the superior temporal gyrus, cuneus, midbrain, and cerebellum.
Conclusions:
- This meta-analysis confirms that MOH is associated with structural brain modifications in reward and pain networks.
- The findings suggest potentially reversible morphologic changes in the pain network following medication withdrawal.
- Further functional and longitudinal studies are recommended to elucidate the causal mechanisms of MOH.
