Medication Overuse Headache and Myofascial Pain: Frequent Under-Diagnosed Conditions Related to Chronic Headache Patients. A Re-view of The Literature and Clinical Report

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.

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Treatment and outcome in medication overuse headache patients

The Journal of Headache and Pain ◽

10.1186/1129-2377-14-s1-p180 ◽

2013 ◽

Vol 14 (S1) ◽

Author(s):

D Mitsikostas ◽

I Deligianni

Keyword(s):

Medication Overuse ◽

Medication Overuse Headache ◽

Headache Patients

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Prevalence of Secondary Chronic Headaches in a Population-Based Sample of 30-44-Year-Old Persons. The Akershus Study of Chronic Headache

Cephalalgia ◽

10.1111/j.1468-2982.2008.01577.x ◽

2008 ◽

Vol 28 (7) ◽

pp. 705-713 ◽

Cited By ~ 101

Author(s):

K Aaseth ◽

RB Grande ◽

KJ Kvárner ◽

P Gulbrandsen ◽

C Lundqvist ◽

...

Keyword(s):

Chronic Headache ◽

Response Rate ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Participation Rate ◽

Population Based ◽

Cervicogenic Headache ◽

Questionnaire Response ◽

Chronic Headaches

We studied secondary chronic headaches (≥ 15 days/month for at least 3 months) in a random sample of 30 000 persons aged 30-44 years. They received a mailed questionnaire. Those with self-reported chronic headache within the last month and/or year were invited to an interview and examination by a neurological resident. The criteria of the International Classification of Headache Disorders (ICHD-II) were applied. The questionnaire response rate was 71%, and the participation rate of the interview was 74%. Of the 633 participants, 298 had a secondary chronic headache. The 1-year prevalence of secondary chronic headache was 2.14%, i.e. chronic posttraumatic headache 0.21%, chronic headache attributed to whiplash injury 0.17%, post-craniotomy headache 0.02%, medication-overuse headache (MOH) 1.72%, cervicogenic headache 0.17%, headache attributed to chronic rhinosinusitis 0.33% and miscellaneous headaches 0.04%. The majority of those with ICHD-II-defined secondary chronic headache had MOH, while about one-third had other secondary headaches often in combination with MOH.

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Chronic Daily Headache and Medication Overuse Headache in First-Visit Headache Patients in Korea: A Multicenter Clinic-Based Study

Journal of Clinical Neurology ◽

10.3988/jcn.2016.12.3.316 ◽

2016 ◽

Vol 12 (3) ◽

pp. 316 ◽

Cited By ~ 5

Author(s):

Myoung-Jin Cha ◽

Heui-Soo Moon ◽

Jong-Hee Sohn ◽

Byung-Su Kim ◽

Tae-Jin Song ◽

...

Keyword(s):

Chronic Daily Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Daily Headache ◽

Headache Patients

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O070. The association between temperament, depression, hopelessness and quality of life in medication-overuse headache patients

The Journal of Headache and Pain ◽

10.1186/1129-2377-16-s1-a51 ◽

2015 ◽

Vol 16 (S1) ◽

Cited By ~ 1

Author(s):

Monica Migliorati ◽

Federica Ricci ◽

Denise Erbuto ◽

Samantha Bellini ◽

Maurizio Pompili

Keyword(s):

Quality Of Life ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Headache Patients

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Exploration of candidate serum biomarkers potentially related to the chronic pain condition in Medication Overuse Headache (MOH)

10.21203/rs.2.9106/v1 ◽

2019 ◽

Author(s):

Lanfranco Pellesi ◽

Elisa Bellei ◽

Simona Guerzoni ◽

Maria Michela Cainazzo ◽

Carlo Baraldi ◽

...

Keyword(s):

Neuropathic Pain ◽

Correlation Coefficient ◽

Trigeminal Nerve ◽

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Serum Levels ◽

Apolipoprotein A1 ◽

Serum Concentrations ◽

Healthy Individuals

Abstract Background Medication Overuse Headache (MOH) is a prevalent and disabling disorder resulting from the overuse of analgesic drugs, triptans or other acute headache medications. In previous proteomic studies, several proteins have been found at high concentrations in the urine of MOH patients and in the serum of rats with neuropathic pain. The aim of this study was to compare the serum levels of lipocalin-type Prostaglandin D2 synthase (L-PGDS), Vitamin D-binding protein (VDBP), apolipoprotein E (APOE) and apolipoprotein A1 (APOA1) in MOH patients and healthy individuals, further exploring their relationship with cutaneous pain thresholds (CPTs) in the territories innervated by the trigeminal nerve. Methods 69 MOH patients and 42 age- and sex-matched healthy volunteers were enrolled in the study. Von Frey-like filaments were applied to the skin territories innervated by the trigeminal nerve, to determine the CPTs. L-PGDS, VDBP, APOE and APOA1 were quantified in the serum by Enzyme-linked Immunosorbent Assay (ELISA). Clinical and laboratory data were collected. Comparisons between MOH patients and healthy individuals were performed using independent t test or χ2 test. To correlate serum proteins with CPTs, Pearson correlation coefficient or Spearman's rank correlation coefficient were used. Results CPTs were lower among MOH patients. L-PGDS, VDBP and APOE had significantly different serum concentrations between groups (p < 0.01), but no correlation was found with CPTs. APOA1 serum concentrations did not differ between patients and healthy individuals. Conclusions L-PGDS, VDBP and APOE had abnormal serum levels in MOH patients, confirming their alteration in some conditions of chronic headache and neuropathic pain. The in-depth study of target proteins represents a promising approach for a better understanding of MOH, as well as the detection of candidate biomarkers for chronic headache or the risks associated with overuse medications.

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6. Glutamate Receptor Ionotropic AMPA 3 (GRIA3) gene polymorphism influences cortical response to somatosensory stimulation in medication-overuse headache patients

Clinical Neurophysiology ◽

10.1016/j.clinph.2016.10.018 ◽

2016 ◽

Vol 127 (12) ◽

pp. e324

Author(s):

G. Coppola ◽

C. Di Lorenzo ◽

G.S. Grieco ◽

M. Santoro ◽

F.M. Santorelli ◽

...

Keyword(s):

Gene Polymorphism ◽

Glutamate Receptor ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Cortical Response ◽

Somatosensory Stimulation ◽

Headache Patients

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Remission of chronic headache: An 11-year follow-up study. Data from the Nord-Trøndelag Health Surveys 1995–1997 and 2006–2008

Cephalalgia ◽

10.1177/0333102418769940 ◽

2018 ◽

Vol 38 (14) ◽

pp. 2026-2034 ◽

Cited By ~ 2

Author(s):

Knut Hagen ◽

Espen Saxhaug Kristoffersen ◽

Bendik Slagvold Winsvold ◽

Lars Jacob Stovner ◽

John-Anker Zwart

Keyword(s):

Cohort Study ◽

Chronic Headache ◽

Response Rate ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Population Based ◽

Study Data ◽

Health Study ◽

Musculoskeletal Complaints

Objectives To estimate remission rates of chronic headache and predictors of remission. Methods In this longitudinal population-based cohort study, we used validated headache questionnaire data from the second (1995–1997, baseline; n = 51,856 aged ≥ 20 years, response rate: 55%) and third wave (2006–2008, follow-up, response rate: 42%) of the Nord-Trøndelag Health Study. Chronic headache was defined as ≥15 headache days/month during the last year. Chronic headache remission was defined as headache less than 15 days/month at follow-up. Potential predictors of remission were evaluated using logistic regression. Results At baseline, 1266 (2.4%) participants reported chronic headache. Of these, 605 (48%) answered headache questions at follow-up. Remission was observed in 452 (74.7%), the proportion being almost identical in men and women (74.4% vs. 74.9, p = 0.92). In analyses adjusting for age, gender and education level, remission at follow-up was more than two times more likely among individuals without medication overuse headache (OR = 2.4, 95% CI 1.7–3.6) and without chronic musculoskeletal complaints (OR = 2.9, 95% CI 1.5–5.0) at baseline. Conclusions In this longitudinal population-based cohort study, three-quarters of chronic headache participants remitted from chronic headache. Remission was associated with no medication overuse headache and no chronic musculoskeletal complaints at baseline.

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