{"title":"Neuroimaging differences between chronic migraine with and without medication overuse headache: a 7 Tesla multimodal MRI study.","authors":"Yin Sun, Longteng Ma, Song Wang, Caohui Duan, Xinyu Wang, Xiangbing Bian, Shuqing Wang, Deqi Zhai, Siyuan Xie, Shuhua Zhang, Yingyuan Liu, Xiaoxue Lin, Ruobing Wang, Xiu Liu, Shengyuan Yu, Xin Lou, Zhao Dong","doi":"10.1186/s10194-025-01988-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic migraine (CM) patients with medication overuse headache (MOH) exhibit distinct neurobiological alterations compared to those without MOH. However, prior studies, often limited to single imaging modalities, have yielded inconsistent findings. This study employs multimodal MRI-combining structural, diffusion tensor, and functional imaging-to characterize brain abnormalities in CM patients with and without MOH, while investigating the relationship between acute analgesic use frequency and these changes.</p><p><strong>Methods: </strong>The study employed comparative analyses to examine differences in gray matter volume, white matter integrity, and spontaneous brain activity between CM patients with (CM + MOH) and without (CM - MOH) medication overuse headache, as well as healthy controls. Additionally, brain regions associated with the frequency of acute medication use were identified and further investigated.</p><p><strong>Results: </strong>Nineteen CM - MOH patients, twenty-five CM + MOH patients, and nineteen healthy controls were enrolled. Compared to CM - MOH patients, CM + MOH patients exhibited significantly reduced gray matter volume in the parahippocampal gyrus and middle occipital gyrus, alongside markedly lower fractional anisotropy (FA) in the left cingulum bundle. Moreover, fractional amplitude of low-frequency fluctuations (fALFF) values in the right putamen were significantly decreased and demonstrated a negative correlation with the frequency of acute pain medication use. Functional connectivity analysis further revealed significantly enhanced connectivity between the right putamen and regions such as the frontal lobe, middle cingulate gyrus, lingual gyrus, and precuneus, which positively correlated with the frequency of acute analgesic use.</p><p><strong>Conclusion: </strong>Compared to CM - MOH patients, those with MOH exhibit distinct patterns of gray matter volume reduction in regions associated with memory and visual processing, accompanied by significant white matter disruption. Additionally, decreased spontaneous activity in the right putamen and heightened functional connectivity between the putamen and multiple brain regions are strongly correlated with the frequency of acute medication use. These results highlight the significant impact of medication overuse on brain structure and function, shedding light on the mechanisms of migraine chronification.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"54"},"PeriodicalIF":7.3000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908087/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Headache and Pain","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s10194-025-01988-3","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Chronic migraine (CM) patients with medication overuse headache (MOH) exhibit distinct neurobiological alterations compared to those without MOH. However, prior studies, often limited to single imaging modalities, have yielded inconsistent findings. This study employs multimodal MRI-combining structural, diffusion tensor, and functional imaging-to characterize brain abnormalities in CM patients with and without MOH, while investigating the relationship between acute analgesic use frequency and these changes.
Methods: The study employed comparative analyses to examine differences in gray matter volume, white matter integrity, and spontaneous brain activity between CM patients with (CM + MOH) and without (CM - MOH) medication overuse headache, as well as healthy controls. Additionally, brain regions associated with the frequency of acute medication use were identified and further investigated.
Results: Nineteen CM - MOH patients, twenty-five CM + MOH patients, and nineteen healthy controls were enrolled. Compared to CM - MOH patients, CM + MOH patients exhibited significantly reduced gray matter volume in the parahippocampal gyrus and middle occipital gyrus, alongside markedly lower fractional anisotropy (FA) in the left cingulum bundle. Moreover, fractional amplitude of low-frequency fluctuations (fALFF) values in the right putamen were significantly decreased and demonstrated a negative correlation with the frequency of acute pain medication use. Functional connectivity analysis further revealed significantly enhanced connectivity between the right putamen and regions such as the frontal lobe, middle cingulate gyrus, lingual gyrus, and precuneus, which positively correlated with the frequency of acute analgesic use.
Conclusion: Compared to CM - MOH patients, those with MOH exhibit distinct patterns of gray matter volume reduction in regions associated with memory and visual processing, accompanied by significant white matter disruption. Additionally, decreased spontaneous activity in the right putamen and heightened functional connectivity between the putamen and multiple brain regions are strongly correlated with the frequency of acute medication use. These results highlight the significant impact of medication overuse on brain structure and function, shedding light on the mechanisms of migraine chronification.
期刊介绍:
The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data.
With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.