Systemic Inflammation and Oxidative Stress Markers in Patients With Medication Overuse Headache

Recent scientific evidence has suggested that inflammation and oxidative stress may play a significant role in the pathogenesis of medication overuse headache (MOH). This study aims to investigate the differences in peripheral markers of systemic inflammation and oxidative stress, such as the monocyte to high-density lipoprotein (HDL) ratio (MHR), and their correlation with clinical symptoms in MOH patients, episodic migraine patients, and healthy controls.

This cross-sectional study recruited MOH patients along with age- and sex-matched controls. Differences in indicators of inflammation and oxidative stress were compared across different groups, including MOH patients with different preexisting headache subtypes. Univariate and multivariate logistic regression analyses were employed to identify independent factors associated with the occurrence of MOH.

The study comprised 109 MOH patients, 68 episodic migraine patients, and 86 healthy controls. MOH patients exhibited significantly higher values of MHR, lymphocyte to HDL ratio (LHR), and neutrophil to HDL ratio (NHR) compared to healthy controls. No statistically significant differences in these indicators were observed between the MOH subgroups. Correlation analysis revealed that only the triglyceride-glucose index was negatively correlated with monthly headache days in MOH patients (r = -0.230, p = 0.016). Additionally, elevated values of MHR odds ratios ((OR) = 2.32, 95% confidence intervals (CI) 1.18-4.56), LHR (OR = 2.56, 95% CI 1.40-4.67), and NHR (OR = 2.09, 95% CI 1.16-3.75) were independently associated with MOH.

MOH patients demonstrated markedly distinct inflammatory and oxidative stress profiles. Elevated values of LHR, MHR, and NHR were independently associated with MOH.