Cortical morphological changes in chronic migraine in a Taiwanese cohort: Surface- and voxel-based analyses

Cephalalgia ◽  
2020 ◽  
Vol 40 (6) ◽  
pp. 575-585 ◽  
Author(s):  
Kuan-Lin Lai ◽  
David M Niddam ◽  
Jong-Ling Fuh ◽  
Wei-Ta Chen ◽  
Jaw-Ching Wu ◽  
...  
Keyword(s):  
Major Depression ◽  
Chronic Migraine ◽  
Cortical Thickness ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Group Differences ◽  
Precentral Gyrus ◽  
Healthy Controls ◽  
Voxel Based Morphometry ◽  
Surface Based Morphometry

Background Previous voxel- or surface-based morphometric analysis studies have revealed alterations in cortical structure in patients with chronic migraine, yet with inconsistent results. The discrepancies may be derived partly from the sample heterogeneity. Employing both methods in a clinically homogenous group may provide a clearer view. Methods Structural MRI data from 30 prevention-naïve patients with chronic migraine without medication overuse headache or a history of major depression and 30 healthy controls were analyzed. Vertex-wise (surface-based) or voxel-wise (voxel-based) linear models were applied, after controlling for age and gender, to investigate between-group differences. Averaged cortical thicknesses and volumes from regions showing group differences were correlated with parameters related to clinical profiles. Results Surface-based morphometry showed significantly thinner cortices in the bilateral insular cortex, caudal middle frontal gyrus, precentral gyrus, and parietal lobes in patients with chronic migraine relative to healthy controls. Additionally, the number of migraine days in the month preceding MRI examination was correlated negatively with right insular cortical thickness. Voxel-based morphometry (VBM) did not show any group differences or clinical correlations. Conclusion Patients with chronic migraine without medication overuse headache, major depression, or prior preventive treatment had reduced cortical thickness in regions within the pain-processing network. Compared to voxel-based morphometry, surface-based morphometry analysis may be more sensitive to subtle structural differences between healthy controls and patients with chronic migraine.

Brain metabolites in chronic migraine patients with medication overuse headache

Cephalalgia ◽  
2020 ◽  
Vol 40 (8) ◽  
pp. 851-862 ◽  
Author(s):  
David M Niddam ◽  
Kuan-Lin Lai ◽  
Shang-Yueh Tsai ◽  
Yi-Ru Lin ◽  
Wei-Ta Chen ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Anterior Cingulate Cortex ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Cingulate Cortex ◽  
Anterior Cingulate ◽  
Brain Metabolites ◽  
Healthy Controls ◽  
The Right ◽  
Thalamocortical Pathway

Background Medication overuse headache may be associated with widespread alterations along the thalamocortical pathway, a pathway involved in pain perception and disease progression. This study addressed whether brain metabolites in key regions of the thalamocortical pathway differed between chronic migraine patients with medication overuse headache and without medication overuse headache. Methods Magnetic resonance spectroscopic imaging was used to map metabolites in the bilateral anterior cingulate cortices, mid cingulate cortices, posterior cingulate cortices, and the thalami. Sixteen patients with medication overuse headache were compared with 16 matched patients without medication overuse headache and 16 matched healthy controls. Results Glutamate and glutamine in the right mid cingulate cortex and myo-inositol in the left anterior cingulate cortex were significantly higher in patients with medication overuse headache than patients without medication overuse headache, but similar to healthy controls. Both patient groups exhibited reduced N-acetyl-aspartate and creatine in the thalamus, reduced myo-inositol in the right anterior cingulate cortex, and elevated choline in the right mid cingulate cortex. Finally, a negative association between myo-inositol laterality index in the anterior cingulate cortices and number of days per month with acute medication use was found across all patients. Conclusions Patients with medication overuse headache were characterized by a distinct concentration profile of myo-inositol, a glial marker, in the anterior cingulate cortices that may have arisen from medication overuse and could contribute to the development of medication overuse headache.

HLA class I alleles are associated with clinic-based migraine and increased risks of chronic migraine and medication overuse

Cephalalgia ◽  
2020 ◽  
Vol 40 (5) ◽  
pp. 493-502
Author(s):  
Claire Huang ◽  
Shih-Pin Chen ◽  
Yu-Han Huang ◽  
Hsuan-Yu Chen ◽  
Yen-Feng Wang ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medical Center ◽  
Medication Overuse Headache ◽  
Human Leukocyte ◽  
Population Based ◽  
Class I ◽  
Leukocyte Antigen ◽  
Antigen B

Objective We aimed to evaluate associations of human leukocyte antigen variants with migraine or headache in hospital and population-based settings. Methods The case-control study population, aged 30–70, included 605 clinic-based migraine patients in a medical center and 8449 population-based participants in Taiwan Biobank (TWB). Clinic-based cases were ascertained by neurologists. Participants in Taiwan Biobank were interviewed by a structured questionnaire including headache and migraine history; among them, 2394 had headache or migraine history while 6055 were free of headache and served as controls. All subjects were genotyped by Axiom Genome-Wide Single Nucleotide Polymorphism Arrays and imputed for eight classical human leukocyte antigen genes. Human leukocyte antigen frequencies were compared between clinic-based and self-reported patients and controls. We utilized likelihood ratio tests to examine human leukocyte antigen-disease associations and logistic regressions to estimate the effect of human leukocyte antigen alleles on migraine. Results Human leukocyte antigen -B and C showed significant associations with clinic-based migraine ( q-value < 0.05). Human leukocyte antigen -B*39:01, human leukocyte antigen -B*51:01, human leukocyte antigen -B*58:01 and human leukocyte antigen -C*03:02 were significantly associated with migraine, with age and sex-adjusted odds ratios (95% CIs) of 1.80 (1.28–2.53), 1.50 (1.15–1.97), 1.36 (1.14–1.62) and 1.36 (1.14–1.62), correspondingly. Clinic-based migraineurs carrying human leukocyte antigen -B*58:01 or human leukocyte antigen -C*03:02 had 1.63 (1.11–2.39) -fold likelihood to have chronic migraine with medication-overuse headache compared to episodic migraine. However, no human leukocyte antigen genes were associated with self-reported headache or migraine in the community. Conclusions Human leukocyte antigen class I genetic variants are positively associated with risk of clinic-based migraine but not self-reported migraine or headache and may contribute to migraine chronification and medication overuse.

scholarly journals Increased cerebral responses to salient transitions between alternating stimuli in chronic migraine with medication overuse headache and during migraine attacks

Cephalalgia ◽  
2019 ◽  
Vol 39 (8) ◽  
pp. 988-999 ◽  
Author(s):  
Volodymyr B Bogdanov ◽  
Olena V Bogdanova ◽  
Alessandro Viganò ◽  
Quentin Noirhomme ◽  
Steven Laureys ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Blood Oxygenation Level Dependent ◽  
Pain Modulation ◽  
Blood Oxygenation ◽  
Blood Oxygenation Level ◽  
Oxygenation Level ◽  
Headache Patients

Introduction In a previous study exploring central pain modulation with heterotopic stimuli in healthy volunteers, we found that transitions between sustained noxious and innocuous thermal stimulations on the foot activated the “salience matrix”. Knowing that central sensory processing is abnormal in migraine, we searched in the present study for possible abnormalities of these salient transitional responses in different forms of migraine and at different time points of the migraine cycle. Methods Participants of both sexes, mostly females, took part in a conditioned pain modulation experiment: Migraineurs between (n = 14) and during attacks (n = 5), chronic migraine patients with medication overuse headache (n = 7) and healthy volunteers (n = 24). To evoke the salience response, continuous noxious cold or innocuous warm stimulations were alternatively applied on the right foot. Cerebral blood oxygenation level dependent responses were recorded with fMRI. Results Switching between the two stimulations caused a significant transition response in the “salience matrix” in all subject groups (effect of the condition). Moreover, some group effects appeared on subsequent post-hoc analyses. Augmented transitional blood oxygenation level dependent responses in the motor cortex and superior temporal sulcus were found in two patient groups compared to healthy controls: chronic migraine with medication overuse headache patients and migraineurs recorded during an attack. In chronic migraine with medication overuse headache patients, salience-related responses were moreover greater in the premotor cortex, supplementary motor area, lingual gyrus and dorso-medial prefrontal cortex and other “salience matrix” areas, such as the anterior cingulate and primary somatosensory cortices. Conclusion This study shows salience-related hyperactivation of affective and motor control areas in chronic migraine with medication overuse headache patients and, to a lesser extent, in episodic migraine patients during an attack. The greater extension of exaggerated blood oxygenation level dependent responses to unspecific salient stimuli in chronic migraine with medication overuse headache than during a migraine attack could be relevant for headache chronification.

Involvement of Corticotrophin-Releasing Factor and Orexin-A in Chronic Migraine and Medication-Overuse Headache: Findings From Cerebrospinal Fluid

Cephalalgia ◽  
2008 ◽  
Vol 28 (7) ◽  
pp. 714-722 ◽  
Author(s):  
P Sarchielli ◽  
I Rainero ◽  
F Coppola ◽  
C Rossi ◽  
ML Mancini ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Potential Role ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Orexin A ◽  
Compensatory Response ◽  
Corticotrophin Releasing Factor ◽  
Response To Stress ◽  
The Brain

The study set out to investigate the role of corticotrophin-releasing factor (CRF) and orexin-A in chronic migraine (CM) and medication-overuse headache (MOH). Twenty-seven patients affected by CM and 30 with MOH were enrolled. Control CSF specimens were obtained from 20 age-matched subjects who underwent lumbar puncture for diagnostic purposes, and in all of them CSF and blood tests excluded central nervous system or systemic diseases. Orexin-A and CRF were determined by radioimmunoassay methods. Significantly higher levels of orexin-A and CRF were found in the CSF of MOH and to a lesser extent in patients with CM compared with control subjects (orexin-A: P < 0.001 and P < 0.02; CRF: P < 0.002 and P < 0.0003). A significant positive correlation was also found between CSF orexin-A values and those of CRF ( R = 0.71; P < 0.0008), monthly drug intake group ( R = 0.39; P < 0.03) and scores of a self-completion 10-item instrument to measure dependence upon a variety of substances, the Leeds Dependence Questionnaire (LDQ) in the MOH group ( R = 0.68; P < 0.0003). The significantly higher orexin-A levels found in CM and MOH can be interpreted as a compensatory response to chronic head pain or, alternatively, as an expression of hypothalamic response to stress due to chronic pain. A potential role for orexin-A in driving drug seeking in MOH patients through activation of stress pathways in the brain can also be hypothesized.

scholarly journals Brain functional connectivity and morphology changes in medication-overuse headache: Clue for dependence-related processes?

Cephalalgia ◽  
2014 ◽  
Vol 34 (8) ◽  
pp. 605-615 ◽  
Author(s):  
S Chanraud ◽  
G Di Scala ◽  
B Dilharreguy ◽  
J Schoenen ◽  
M Allard ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Gray Matter ◽  
Default Mode Network ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Voxel Based Morphometry ◽  
Whole Brain ◽  
Default Mode ◽  
Brain Functional Connectivity ◽  
Gray Matter Volumes

Background Several imaging studies have identified localized anatomical and functional brain changes in medication-overuse headache (MOH). Objective The objective of this article is to evaluate whole-brain functional connectivity at rest together with voxel-based morphometry in MOH patients, in comparison with episodic migraine (EM) patients and healthy controls (HCs). Methods Anatomical MRI and resting-state functional MRI scans were obtained in MOH patients ( n = 17 and 9, respectively), EM patients ( n = 18 and 15, respectively) and HCs ( n = 17 and 17). SPM8 was used to analyze voxel-based morphometry and seed (left precuneus) to voxel connectivity data in the whole brain. Results Functional connectivity at rest was altered in MOH patients. Connectivity was decreased between precuneus and regions of the default-mode network (frontal and parietal cortices), but increased between precuneus and hippocampal/temporal areas. These functional modifications were not accompanied by significant gross morphological changes. Furthermore, connectivity between precuneus and frontal areas in MOH was negatively correlated with migraine duration and positively correlated with self-evaluation of medication dependence. Gray matter volumes of frontal regions, precuneus and hippocampus were also negatively related to migraine duration. Functional connectivity within the default-mode network appeared to predict anxiety scores of MOH patients while gray matter volumes in this network predicted their depression scores. Conclusions Our data suggest that MOH is associated with functional alterations within intrinsic brain networks rather than with macrostructural changes. They also support the view that dependence-related processes might play a prominent role in its development and maintenance.

scholarly journals P.033 Eptinezumab reduced acute medication use in patients with chronic migraine and medication-overuse headache: subgroup analysis of Promise-2

2021 ◽  
Vol 48 (s3) ◽  
pp. S29-S29
Author(s):  
MJ Marmura ◽  
H Diener ◽  
J Hirman ◽  
R Cady ◽  
T Brevig ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Baseline Period ◽  
Migraine Treatment ◽  
Medication History ◽  
Medication Class ◽  
The Us ◽  
Acute Headache ◽  
The Impact

Background: Eptinezumab is a preventive migraine treatment approved in the US. We evaluated the impact of eptinezumab on acute headache medication (AHM) use in patients diagnosed with chronic migraine (CM) and medication-overuse headache (MOH) in PROMISE-2. Methods: PROMISE-2 randomized patients with CM to eptinezumab 100mg, 300mg, or placebo for 2 intravenous doses administered every 12 weeks. Trained investigators diagnosed MOH at screening using 3-month medication history and ICHD-3b criteria. Endpoints included days/month of any AHM use (days of ≥1 medication class), total AHM use (summed days for each medication class), and triptan use over Weeks 1-12 and 13-24. AHM classes included triptan, ergot, opioid, simple analgesic, and combination analgesic. Results: Of 1072 PROMISE-2 patients, 431 (40.2%) were diagnosed with MOH (100mg, n=139; 300mg, n=147; placebo, n=145). During the 28-day baseline period, mean days of any AHM was ~16.4, total AHM was ~20.4, and triptan was ~8.9 across treatment arms. Over Weeks 1-12, mean days/month of any AHM was 8.8 (100mg), 9.9 (300mg), and 11.8 (placebo); total AHM was 10.8, 12.2, and 14.8; triptan was 4.3, 4.4, and 6.4. Similar or lower rates were observed over Weeks 13-24. Conclusions: In patients diagnosed with both CM and MOH, eptinezumab treatment reduced AHM use.

scholarly journals Flunarizine is more effective than topiramate in patients with chronic migraine and medication overuse headache

2013 ◽  
Vol 14 (Suppl 1) ◽  
pp. P202
Author(s):  
M Gracia-Naya ◽  
N Hernando-Quintana ◽  
MJ García-Gomara ◽  
S Sánchez-Valiente ◽  
C Ríos ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache

scholarly journals Reduced Grey Matter Volume in Frontal and Temporal Areas in Depression: A Voxel Based Morphometry Study

2019 ◽  
Author(s):  
Sevdalina Kandilarova ◽  
Drozdstoy Stoyanov ◽  
Nickolay Sirakov ◽  
Michael Maes ◽  
Karsten Specht
Keyword(s):  
Bipolar Disorder ◽  
Major Depression ◽  
Mood Disorders ◽  
Grey Matter ◽  
Inferior Frontal Gyrus ◽  
Anterior Cingulate ◽  
Middle Temporal Gyrus ◽  
Grey Matter Volume ◽  
Healthy Controls ◽  
Voxel Based Morphometry

Objective: The aim of the current study was to examine whether and to what extent mood disorders, comprising major depression and bipolar disorder, are accompanied by structural changes in the brain as measured using voxel-based morphometry (VBM). Methods: We have performed a VBM study using a 3Т MRI system (GE Discovery 750w) in patients with mood disorders (n=50), namely 39 with major depression and 11 with bipolar disorder, compared to 42 age, sex and education matched healthy controls. Results: Our results show that depression was associated with significant decreases in grey matter (GM) volume restricted to regions located in medial frontal and anterior cingulate cortex on the left side and middle frontal gyrus, medial orbital gyrus, inferior frontal gyrus (triangular and orbital parts), and middle temporal gyrus (extending to the superior temporal gyrus) on the right side. When the patient group was separated into bipolar disorder and major depression the reductions remained significant only for the patients with major depressive disorder. Conclusions: Using VBM the present study was able to replicate decreases in GM volume restricted to frontal and temporal regions in patients with mood disorders mainly major depression, as compared with healthy controls.&nbsp;

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