scholarly journals Medication overuse headache associated with decreased dopamine transporter availability in the left orbitofrontal cortex: A 11CFT PET/MR study

2021 ◽  
Author(s):  
Huanxian Liu ◽  
Jiajin Liu ◽  
Shuping Sun ◽  
Wei Dai ◽  
Binbin Nie ◽  
...  
Keyword(s):  
Dopamine Transporter ◽  
Orbitofrontal Cortex ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Standardized Uptake Value ◽  
Brain Regions ◽  
Seed Region ◽  
Dopamine System ◽  
Mesocorticolimbic Dopamine System ◽  
Clinical Measures

Abstract BackgroundsThe dysfunction of dopamine in the mesocorticolimbic dopamine system in MOH is unknown. Dopamine transporter (DAT) regulates dopamine clearance and neurotransmission and is sensitive to dopamine levels. A decrease in DAT availability can reflect a decrease in dopamine. To determine DAT availability abnormalities in the mesocorticolimbic dopamine system and explore functional network changes in medication overuse headache (MOH) patients.MethodsWe examined 17 MOH patients and 16 healthy controls (HCs) using integrated positron emission tomography (PET)/magnetic resonance (MR) brain scans with 11CFT, a radioligand that binds to DAT. Standardized uptake value ratio (SUVr) images were compared voxelwise between MOH patients and HCs. Then, the significantly changed cluster (p < 0.01, GRF correction) with abnormal DAT availability was selected as a specific seed region to further evaluate altered functional connectivity (FC) in MOH. SUVr and mean FC values from significantly changed regions were extracted, and partial correlation analyses with clinical measures were conducted.ResultsMOH patients had lower SUVr levels in the left rather than right orbitofrontal cortex (OFC) than HCs. There was altered FC between the left OFC and the left superior temporal pole and bilateral calcarine gyri. SUVr levels in the left OFC and the connectivity strength linking the positive brain regions with the left OFC were not correlated with clinical measures in the MOH patients.ConclusionsMOH is characterized by decreased DAT availability in the left OFC, which might reflect compensatory downregulation due to low dopamine signalling within the mesocorticolimbic dopamine system. In addition, the OFC on both sides may have different functions in the pathogenesis of MOH. Altered intrinsic FC in the left OFC was identified in MOH patients, which may provide a new perspective to understand the pathogenesis of MOH.

scholarly journals Evaluation of structural changes in orbitofrontal cortex in relation to medication overuse in migraine patients: a diffusion tensor imaging study

2021 ◽  
Vol 79 (6) ◽  
pp. 483-488
Author(s):  
Aygul Tantik Pak ◽  
Sebahat Nacar Dogan ◽  
Yildizhan Sengul
Keyword(s):  
Diffusion Tensor Imaging ◽  
Orbitofrontal Cortex ◽  
Structural Changes ◽  
Medication Overuse ◽  
Diffusion Tensor ◽  
Medication Overuse Headache ◽  
Treatment Strategies ◽  
Imaging Study ◽  
Primary Headaches ◽  
Significant Difference

Abstract Background: Migraine is a prevalent neurological disease that leads to severe headaches. Moreover, it is the commonest among the primary headaches that cause medication overuse headache (MOH). The orbitofrontal cortex (OFC) is one of the structures most associated with medication overuse. Objective: To determine microstructural changes in the OFC among migraine patients who developed MOH, through the diffusion tensor imaging (DTI) technique. Methods: Fifty-eight patients who had been diagnosed with migraine based on the Classification of Headache Disorders (ICHD-III-B) were included in the study. Patients were sub-classified into two groups, with and without MOH, based on the MOH criteria of ICHD-III-B. DTI was applied to each patient. The OFC fractional anisotropy (FA), and apparent diffusion coefficient (ADC) values of the two groups were compared. Results: The mean age of all the patients was 35.98±7.92 years (range: 18-65), and 84.5% (n=49) of them were female. The two groups, with MOH (n=25) and without (n=33), were alike in terms of age, gender, family history, migraine with or without aura and duration of illness. It was found that there was a significant difference in FA values of the left OFC between the two groups (0.32±0.01 versus 0.29±0.01; p=0.04). Conclusions: An association was found between MOH and changes to OFC microstructure. Determination of neuropathology and factors associated with medication overuse among migraine patients is crucial in terms of identifying the at-risk patient population and improving proper treatment strategies specific to these patients.

scholarly journals Vasoactive intestinal polypeptide plasma levels associated with affective symptoms and brain structure and function in healthy females

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rozalyn A. Simon ◽  
Nawroz Barazanji ◽  
Michael P. Jones ◽  
Olga Bednarska ◽  
Adriane Icenhour ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Vasoactive Intestinal Polypeptide ◽  
Orbitofrontal Cortex ◽  
Brain Volume ◽  
Brain Regions ◽  
Anxiety And Depression ◽  
Seed Region ◽  
Affective Symptoms ◽  
Healthy Females ◽  
Intestinal Polypeptide

AbstractVasoactive intestinal polypeptide (VIP) is a neuroendocrine peptide distributed throughout the human body, including the CNS, where it is particularly abundant in brain regions associated with anxiety and depression. Based on earlier studies indicating that peripheral VIP may cross through the blood–brain barrier, we hypothesized plasma VIP levels to be associated with symptoms of anxiety and depression, as well as brain volume and resting-state functional connectivity in the amygdala, hippocampus, parahippocampus, and orbitofrontal cortex. Plasma VIP concentrations and anxiety/depression symptoms were measured in 37 healthy females. Functional and structural magnetic resonance imaging were used to evaluate functional connectivity and brain volume respectively, and their associations with VIP concentrations within brain regions associated with anxiety and depression. Negative correlations were found between VIP levels and symptoms of anxiety (r = − 0.44, p = 0.002) and depression (r = − 0.50, p = 0.001). Functional connectivity demonstrated significant VIP-dependent positive associations between the amygdala seed region with both the right parahippocampus (t(33) = 3.1, pFDR = 0.02) and right lateral orbitofrontal cortex (OFC; t(33) = 2.9, pFDR = 0.02). Moreover, VIP concentrations were significantly, positively correlated with brain volume in the left amygdala (r = 0.28, p = 0.007) and left lateral OFC (r = 0.29, p = 0.004). The present findings highlight a potential role for VIP in the neurobiology of affective symptoms.

Growth of prefrontal and limbic brain regions and anxiety disorders in children born very preterm

2021 ◽  
pp. 1-12
Author(s):  
Courtney P. Gilchrist ◽  
Deanne K. Thompson ◽  
Bonnie Alexander ◽  
Claire E. Kelly ◽  
Karli Treyvaud ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Orbitofrontal Cortex ◽  
Developmental Trajectories ◽  
Brain Regions ◽  
Social Risk ◽  
Intracranial Volume ◽  
Total Brain Volume ◽  
Very Preterm ◽  
The Right

Abstract Background Children born very preterm (VP) display altered growth in corticolimbic structures compared with full-term peers. Given the association between the cortiocolimbic system and anxiety, this study aimed to compare developmental trajectories of corticolimbic regions in VP children with and without anxiety diagnosis at 13 years. Methods MRI data from 124 VP children were used to calculate whole brain and corticolimbic region volumes at term-equivalent age (TEA), 7 and 13 years. The presence of an anxiety disorder was assessed at 13 years using a structured clinical interview. Results VP children who met criteria for an anxiety disorder at 13 years (n = 16) displayed altered trajectories for intracranial volume (ICV, p < 0.0001), total brain volume (TBV, p = 0.029), the right amygdala (p = 0.0009) and left hippocampus (p = 0.029) compared with VP children without anxiety (n = 108), with trends in the right hippocampus (p = 0.062) and left medial orbitofrontal cortex (p = 0.079). Altered trajectories predominantly reflected slower growth in early childhood (0–7 years) for ICV (β = −0.461, p = 0.020), TBV (β = −0.503, p = 0.021), left (β = −0.518, p = 0.020) and right hippocampi (β = −0.469, p = 0.020) and left medial orbitofrontal cortex (β = −0.761, p = 0.020) and did not persist after adjusting for TBV and social risk. Conclusions Region- and time-specific alterations in the development of the corticolimbic system in children born VP may help to explain an increase in anxiety disorders observed in this population.

Analysis on the risk factors of medication-overuse headache in Chinese patients

2018 ◽  
Vol 48 ◽  
pp. 153-159
Author(s):  
Junxia Li ◽  
Chunfu Chen ◽  
Ligong Zhang ◽  
Xiaochen Cui ◽  
Chuanqiao Wei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Chinese Patients

Outcome of Medication Overuse Headache after Abrupt in-Patient withdrawal

Cephalalgia ◽  
2006 ◽  
Vol 26 (5) ◽  
pp. 589-596 ◽  
Author(s):  
G Relja ◽  
A Granato ◽  
A Bratina ◽  
RM Antonello ◽  
M Zorzon
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Primary Headache ◽  
Drug Intake ◽  
Patient Withdrawal ◽  
Abrupt Discontinuation ◽  
Medication Abuse ◽  
Daily Headache ◽  
Mean Time

One hundred and one patients suffering from chronic daily headache (CDH) and medication overuse were treated, in an in-patient setting, with abrupt discontinuation of the medication overused, intravenous hydrating, and intravenous administration of benzodiazepines and ademetionine. The mean time to CDH resolution was 8.8 days. The in-patient withdrawal protocol used was effective, safe and well tolerated. There was a trend for a shorter time to CDH resolution in patients who overused triptans ( P = 0.062). There was no correlation between time to CDH resolution and either the type of initial primary headache or duration of medication abuse, whereas time to CDH resolution was related to daily drug intake ( P = 0.01). In multiple regression analysis, daily drug intake, age and type of medication overused were independent predictors of time to CDH resolution. At 3-months' follow-up, no patient had relapsed and was again overusing symptomatic medications.

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