1
|
Oh SY, Kang JJ, Park HK, Cho SJ, Hong Y, Kang MK, Moon HS, Lee MJ, Song TJ, Suh YJ, Chu MK. Three-month treatment outcome of medication-overuse headache according to classes of overused medications, use of acute medications, and preventive treatments. Sci Rep 2024; 14:16013. [PMID: 38992145 PMCID: PMC11239667 DOI: 10.1038/s41598-024-66906-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/05/2024] [Indexed: 07/13/2024] Open
Abstract
Medication overuse headache (MOH) is a chronic headache disorder that results from excessive use of acutely symptomatic headache medications, leading to more frequent and severe headaches. This study aims to assess the 3-month treatment outcomes in MOH patients, focusing on the types and usage of overused medications, as well as preventive treatments. This prospective cross-sectional study analyzed the treatment outcomes of 309 MOH patients from April 2020 to March 2022. Patients were advised to discontinue overused medications immediately and offered preventive treatments based on clinical judgment. Data on headache characteristics, medication use, and impact on daily life were collected at baseline and 3 months. Results showed overall significant improvements in headache-related variables in patients completing the 3-month treatment follow-up. The median number of headache days per month decreased from 15 days at baseline to 8 days after 3 months (p < 0.001). Patients who overused multiple drug classes demonstrated increased disability levels (mean Headache Impact Test-6 score: 62 at baseline vs. 56 at 3 months, p < 0.01). Those who continued overusing medications reported more days of severe headache (mean 18 days at baseline vs. 14 days at 3 months, p < 0.05) and greater impact (mean Migraine Disability Assessment score: 35 at baseline vs. 28 after 3 months, p < 0.05) compared to the baseline. Differences in headache outcomes were evident across different preventive treatment groups, with generalized estimating equation analyses highlighting significant associations between clinical characteristics, overused medication classes, and preventive treatments. Most MOH clinical features significantly improved after 3 months of treatment. However, notable interactions were observed with certain clinical presentations, suggesting possible influences of overused medication classes, usage patterns, and preventive treatment types on MOH treatment outcomes. This study underscores the importance of individualized treatment strategies and the potential benefits of discontinuing overused medications.
Collapse
Affiliation(s)
- Sun-Young Oh
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
| | - Jin-Ju Kang
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
| | - Hong-Kyun Park
- Department of Neurology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Yooha Hong
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Mi-Kyoung Kang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Heui-Soo Moon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mi Ji Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, South Korea.
| |
Collapse
|
2
|
Rizzoli P. Medication-Overuse Headache. Continuum (Minneap Minn) 2024; 30:379-390. [PMID: 38568489 DOI: 10.1212/con.0000000000001403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Medication-overuse headache (MOH) has been described for almost 100 years and is characterized as a daily or near-daily headache that usually presents in patients with preexisting primary headache disorders who are overusing one or more acute or symptomatic headache medications. This article reviews the diagnosis and management of patients with MOH. LATEST DEVELOPMENTS The International Classification of Headache Disorders criteria for MOH have changed over time. The worldwide prevalence appears to be between 1% and 2%. Together, headache disorders, including MOH, are currently ranked as the second leading cause of years lived with disability in the Global Burden of Disease world health survey. Significant neurophysiologic changes are seen in the brains of patients with MOH, including functional alterations in central pain processing and modulating systems and central sensitization. Research supports updates to the principles of management, including weaning off the overused medication, preventive therapy, biobehavioral therapy, and patient education. ESSENTIAL POINTS MOH is a fairly common and treatable secondary headache disorder that produces significant disability and a substantial reduction in quality of life. The costs related to lost income and disability are substantial. MOH is intimately related to chronic migraine, which continues to be underrecognized and undertreated. Treatment focuses on both the institution of effective preventive migraine therapy and the reduction or removal of the overused medications. Educational efforts directed toward both providers and patients have been shown to be effective in reducing the effect of MOH.
Collapse
|
3
|
Krymchantowski A, Jevoux C, Krymchantowski AG, Ramos LB, Barbosa JSS, Silva-Neto RP. Medication-overuse headache-a review of different treatment strategies. FRONTIERS IN PAIN RESEARCH 2023; 4:1103497. [PMID: 37881687 PMCID: PMC10597723 DOI: 10.3389/fpain.2023.1103497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/23/2023] [Indexed: 10/27/2023] Open
Abstract
Medication-overuse headache (MOH) can develop from primary headaches. MOH is usually the result of overuse of symptomatic medications. It is a noteworthy personal and societal burden. The identification and treatment of patients at risk for MOH is an essential component of MOH management. Medication overuse can be modifiable and can advance from episodic to chronic migraine. Treatment for MOH is complex, and experts in the field have varied views on the most appropriate strategy for MOH treatment. The objective of this review is to give a comprehensive synopsis of the literature for the management of MOH. Treatment strategies, such as detoxification and prevention, are the debatable issues. Medication withdrawal is the foundation for management. The available literature suggested abrupt withdrawal with preventive approaches for early management. Bridging therapy could be useful to get relief from withdrawal symptoms. Multidisciplinary choices proved beneficial in supporting withdrawal and preventing relapse. Worldwide, the termination of overused medications has been observed as a standard treatment strategy; however, patient-specific approaches should be taken.
Collapse
|
4
|
Tepper SJ, Lipton RB, Silberstein SD, Kudrow D, Ashina M, Reuter U, Dodick DW, Wang A, Cheng S, Klatt J, Mikol DD. Long-term efficacy and safety of erenumab in patients with chronic migraine and acute medication overuse: A subgroup analysis. Headache 2023; 63:730-742. [PMID: 37313616 DOI: 10.1111/head.14536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Assess the long-term efficacy and safety of erenumab in patients with chronic migraine with acute medication overuse. BACKGROUND Overuse of acute medication in patients with chronic migraine has been linked to greater pain intensity and disability and may diminish the effectiveness of preventive therapies. METHODS This 52-week open-label extension study followed a 12-week double-blind placebo-controlled study in which patients with chronic migraine were randomized 3:2:2 to placebo or once-monthly erenumab 70 mg or 140 mg. Patients were stratified by region and medication overuse status. Patients received erenumab 70 mg or 140 mg throughout or switched from erenumab 70 to 140 mg (based on protocol amendment to augment safety data at higher dose). Efficacy was assessed in patients with and without medication overuse at parent study baseline. RESULTS Of 609 patients enrolled in the extension study, 252/609 (41.4%) met the criteria for medication overuse at parent study baseline. At Week 52, the mean change in monthly migraine days from parent study baseline was -9.3 (95% confidence interval: -10.4, -8.1 days) in the medication overuse subgroup versus -9.3 (-10.1, -8.5 days) in the non-medication overuse subgroup (combined erenumab doses); proportion of patients achieving ≥50% reduction in monthly migraine days at Week 52 was 55.9% (90/161; 48.2%, 63.3%) versus 61.3% (136/222; 54.7%, 67.4%), respectively. Among baseline users of acute migraine-specific medication, the mean change in monthly migraine-specific medication days at Week 52 was -7.4 (-8.3, -6.4 days) in the medication overuse subgroup versus -5.4 (-6.1, -4.7 days) in the non-medication overuse subgroup. Most patients (197/298; 66.1%) in the medication overuse subgroup transitioned to non-overuse status by Week 52. Erenumab 140 mg was associated with numerically greater efficacy than erenumab 70 mg across all endpoints. No new safety signals were identified. CONCLUSION Long-term erenumab treatment demonstrated sustained efficacy and safety in patients with chronic migraine with and without acute medication overuse.
Collapse
Affiliation(s)
- Stewart J Tepper
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | | | - Stephen D Silberstein
- Jefferson Headache Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - David Kudrow
- California Medical Clinic for Headache, Santa Monica, California, USA
| | - Messoud Ashina
- Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Uwe Reuter
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Universitätsmedizin Greifswald, Greifswald, Germany
| | - David W Dodick
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | | | | | - Jan Klatt
- Novartis Pharma AG, Basel, Switzerland
| | | |
Collapse
|
5
|
Alpuente A, Torres-Ferrus M, Terwindt GM. Preventive CGRP-targeted therapies for chronic migraine with and without medication-overuse headache. Cephalalgia 2023. [DOI: 10.1177/03331024221150235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Background: Calcitonin gene-related peptide (CGRP) targeted therapies are an important breakthrough in migraine prevention. Randomized clinical trials, post-hoc analyses, and phase IV studies have demonstrated their efficacy and safety in chronic migraine patients, including those with concomitant medication-overuse and medication-overuse headache. Real world evidence studies support these findings and provide realistic endpoints for estimation of effect. Methods and results We have performed a narrative review including results from double-blind placebo-controlled randomized clinical trials and real-world evidence studies regarding efficacy of the CGRP(-receptor) monoclonal antibodies and CGRP-receptor antagonists (gepants) in patients with chronic migraine with concomitant medication overuse (headache). We have included patient profiles and main efficacy endpoints (monthly migraine days, monthly headache days, monthly acute medication days and percentage responder rates). Conclusion The results of this review show that CGRP monoclonal antibodies are effective in chronic migraine patients, also in those with medication overuse (headache). At the time of this review, atogepant clinical trials in chronic migraine have not been communicated. Direct comparative studies are needed for comparison with other treatment options.
Collapse
Affiliation(s)
- Alicia Alpuente
- Headache Clinic, Neurology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Torres-Ferrus
- Headache Clinic, Neurology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gisela M. Terwindt
- Department of Neurology, Leiden Headache Center, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
6
|
Abstract
Medication overuse headache (MOH) is a secondary headache disorder attributed to overuse of acute headache medications by a person with an underlying headache disorder, usually migraine or tension-type headache. MOH is common among individuals with 15 or more headache days per month. Although MOH is associated with substantial disability and reductions in quality of life, this condition is often under-recognized. As MOH is both preventable and treatable, it warrants greater attention and awareness. The diagnosis of MOH is based on the history and an unremarkable neurological examination, and is made according to the diagnostic criteria of the International Classification of Headache Disorders third edition (ICHD-3). Pathophysiological mechanisms of MOH include altered descending pain modulation, central sensitization and biobehavioural factors. Treatment of MOH includes the use of headache preventive therapies, but essential to success is eliminating the cause, by reducing the frequency of use of acute headache medication, and perhaps withdrawing the overused medication altogether. Appropriate treatment is usually highly effective, leading to reduced headache burden and acute medication consumption.
Collapse
|
7
|
Begasse de Dhaem O, Rizzoli P. Refractory Headaches. Semin Neurol 2022; 42:512-522. [DOI: 10.1055/s-0042-1757925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractMedication overuse headache (MOH), new daily persistent headache (NDPH), and persistent refractory headache attributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection represent a significant burden in terms of disability and quality of life, and a challenge in terms of definition, pathophysiology, and treatment. Regarding MOH, prevention without withdrawal is not inferior to prevention with withdrawal. Preventive medications like topiramate, onabotulinumtoxinA, and calcitonin gene-related peptide (CGRP) monoclonal antibodies improve chronic migraine with MOH regardless of withdrawal. The differential diagnosis of NDPH is broad and should be carefully examined. There are no guidelines for the treatment of NDPH, but options include a short course of steroids, nerve blocks, topiramate, nortriptyline, gabapentin, CGRP monoclonal antibodies, and onabotulinumtoxinA. The persistence of headache 3 months after SARS-CoV2 infection is a predictor of poor prognosis.
Collapse
Affiliation(s)
- Olivia Begasse de Dhaem
- Headache Specialist at Hartford HealthCare, Hartford, Connecticut
- Department of Neurology at the University of Connecticut, Milford, Connecticut
| | - Paul Rizzoli
- Department of Neurology, Brigham and Women's Faulkner Hospital J Graham Headache Center, Boston, Massachusetts
| |
Collapse
|
8
|
Lima TACD, Peres MFP, Silberstein SD. Applicability of DSM-V substance use disorder (SUD) criteria in medication overuse headache (MOH). HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2021.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Medication overuse headache (MOH) is a chronic secondary headache disorder attributed to the frequent or regular use of analgesics or acute antimigraine drugs in patients with a primary headache disorder. In addition, it has been linked to substance use disorder (SUD) also known as drug addiction, a persistent use of drugs or substances, despite substantial damage and adverse consequences, diagnosed by DSM-V criteria. At this time, apart from opioids, acute headache medications are not included in SUD. Despite the idea that the compulsive search for reward in MOH is similar to that observed in substance dependence, the DSM-V SUD criteria have never been carefully applied to MOH. We propose to discuss each DSM-V criterion of SUD diagnosis to see whether it is appropriate to use in MOH. We considered it was not-applicable when dealing with a situation that could be explained both by addictive behavior and by poorly controlled primary headache. We conclude that the SUD criteria should not be applied to patients who meet the criteria for MOH.
Collapse
|
9
|
Kong F, Buse DC, Geng J, Xu J, Liu H, Ma S. Efficacy and tolerability of oral gastrodin for medication overuse headache (EASTERN): Study protocol for a multicenter randomized double-blind placebo-controlled trial. Front Neurol 2022; 13:1095298. [PMID: 36910863 PMCID: PMC9993247 DOI: 10.3389/fneur.2022.1095298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/19/2022] [Indexed: 02/24/2023] Open
Abstract
Background Prophylactic medication in clinical detoxification programs for the treatment of medication overuse headache is still debated. Gastrodin, a main bioactive constituent of Rhizoma Gastrodiae, has been applied clinically to treat primary headache for more than 30 years in China due to its potential analgesic and anti-migraine mechanisms. However, clinical evidence supporting its routing use in MOH is insufficient. The present study aims to investigate the efficacy and tolerability of oral gastrodin in medication overuse headache. Methods A multicenter, randomized, double-blind, parallel, placebo-controlled trial will be performed. A target sample size of 186 patients who fulfill the International Classification of Headache Disorders 3rd version (ICHD-3) criteria for MOH will be recruited and screened during a baseline screening period of 28 days before being randomly assigned to either the gastrodin or placebo group at a ratio of 1:1. Enrolled patients will be assessed for each 4 weeks during the 12-weeks double-blind phase and followed up at week 24. The primary endpoint is mean change in monthly headache day frequency. Secondary endpoints will be the proportion of remitted MOH, change in headache pain intensity, headache impact test (HIT-6) score, 50% responder rate, treatment failure, monthly acute medication intake days, and Short Form 36-Item Health Survey (SF-36) score. Tolerability will be assessed by drop-out rates though safety monitoring during treatment. Discussion The findings of the present study may help to provide new evidence on gastrodin as a prophylaxis treatment with both efficacy and high tolerability for the treatment of MOH. Clinical trail registration Chinese Clinical Trail Registry (ChiCTR2200063719), Protocol Version 1.1, May, 09, 2022.
Collapse
Affiliation(s)
- Fanyi Kong
- Department of Neurology, The Affiliated Hospital of Yunnan University, Kunming, Yunnan, China
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Jia Geng
- Department of Neurology, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, Sichuan, China
| | - Jingjing Xu
- Department of Neurology, Xiangya Changde Hospital, Changde, Hunan, China
| | - Hanxiang Liu
- Department of Neurology, Puer People's Hospital, Puer, Yunnan, China
| | - Shu Ma
- Department of Neurology, 920th Hospital of Logistics Support Force, People's Liberation Army, Kunming, Yunnan, China
| |
Collapse
|
10
|
Vides-Rosales M. Pediatric Medication-overuse Headache and Global Headache Research. A Systematic Review. Semin Pediatr Neurol 2021; 40:100937. [PMID: 34749910 DOI: 10.1016/j.spen.2021.100937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
Medication-overuse headache (MOH) is a relevant topic of interest but pediatric studies are scarce. Some authors have expressed their opinion regarding geographical differences in the perceived importance of adult MOH between European and North American research. To determine if there is a geographic difference in the research efforts on pediatric MOH; and to study pediatric MOH prevalence of published studies. An analysis of the Global Burden of Disease database focusing on Headache disorders prevalence per region was correlated with the region where research was conducted via PubMed search on pediatric MOH from 2006-2021. Analysis of databases from PubMed, HINARI, and ScienceDirect found 13 studies that fulfilled inclusion criteria to evaluate pediatric MOH prevalence. 6 regions were analyzed North America, Latin America, Europe, Asia, Africa, Oceania. Regions with higher prevalence of headache disorders were North America (28.45%) and Europe (28.54%). Most pediatric MOH publications were from North America (44.2%) and Europe (37.2%). The prevalence found of pediatric MOH among pediatric headache patients is 4-11%. Prevalence increases to 20-70% among patients having a diagnosis of chronic headache. Higher prevalence was found in patients suffering post traumatic headaches. The perceived importance for pediatric MOH is similar between North America and Europe based on the research published. The prevalence varies greatly between published studies. Relationship between Post-traumatic headache and pediatric MOH prevalence should be further studied.
Collapse
Affiliation(s)
- Manuel Vides-Rosales
- Pediatric Neurology, Clínica Cefaleas - Centro Médico Escalón, San Salvador, El Salvador; Department of Neurosciences, Medical School, Universidad Dr. Jose Matias Delgado, El Salvador.
| |
Collapse
|
11
|
Bottiroli S, Galli F, Ballante E, Pazzi S, Sances G, Guaschino E, Allena M, Tassorelli C. Validity of the Severity of Dependence Scale for detecting dependence behaviours in chronic migraine with medication overuse. Cephalalgia 2021; 42:209-217. [PMID: 34541932 DOI: 10.1177/03331024211039817] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS In this study, we tested the validity of the Severity of Dependence Scale in detecting dependence behaviours in patients with chronic migraine and medication overuse (CM + MO) using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the Leeds Dependence Questionnaire as gold standard measures. METHODS Four hundred and fifty-four patients with CM + MO filled in the Severity of Dependence Scale and the Leeds Dependence Questionnaire and underwent a psychological evaluation for the diagnosis of substance dependence according to the DSM-IV criteria. RESULTS Sixty-nine percent of subjects (n = 313) presented substance dependence according to the DSM-IV criteria. These patients scored significantly higher than those without substance dependence in Severity of Dependence Scale total score (Z = -3.29, p = 0.001), and in items 1 (Z = -2.44, p = 0.015), 2 (Z = -2.50, p = 0.012), 4 (Z = -2.05, p = 0.04), and 5 (Z = -3.39, p = 0.001). Severity of Dependence Scale total score (β = 0.13, SE = 0.04, z = 3.49, p < 0.001) was a significant predictor for substance dependence. Receiver Operating Characteristic (ROC) curves showed that Severity of Dependence Scale discriminated patients with or without substance dependence. CONCLUSION Severity of Dependence Scale could represent an interesting screening tool for dependency-like behaviors in CM + MO patients.
Collapse
Affiliation(s)
- Sara Bottiroli
- Giustino Fortunato University, Benevento, Italy.,Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Federica Galli
- Department of Dynamic and Clinical Psychology, and Health Studies-Faculty of Medicine and Psychology, 9311Sapienza University of Rome, Sapienza University of Rome, Rome, Italy
| | - Elena Ballante
- BioData Science Unit, IRCCS C. Mondino Foundation, Pavia, Italy.,Department of Mathematics, 19001University of Pavia, University of Pavia, Italy
| | - Stefania Pazzi
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Grazia Sances
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Elena Guaschino
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Marta Allena
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Italy
| |
Collapse
|
12
|
Demarquay G, Moisset X, Lantéri-Minet M, de Gaalon S, Donnet A, Giraud P, Guégan-Massardier E, Lucas C, Mawet J, Roos C, Valade D, Ducros A. Revised guidelines of the French Headache Society for the diagnosis and management of migraine in adults. Part 1: Diagnosis and assessment. Rev Neurol (Paris) 2021; 177:725-733. [PMID: 34340812 DOI: 10.1016/j.neurol.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/15/2022]
Abstract
The French Headache Society proposes updated French guidelines for the management of migraine. The first part of these recommendations is focused on the diagnosis and assessment of migraine. First, migraine needs to be precisely diagnosed according to the currently validated criteria of the International Classification of Headache Disorders, 3d version (ICHD-3). Migraine-related disability has to be assessed and we suggest to use the 6 questions of the headache impact test (HIT-6). Then, it is important to check for risk factors and comorbidities increasing the risk to develop chronic migraine, especially frequency of headaches, acute medication overuse and presence of depression. We suggest to use a migraine calendar and the Hospital Anxiety and Depression scale (HAD). It is also necessary to evaluate the efficacy and tolerability of current migraine treatments and we suggest to systematically use the self-administered Migraine Treatment Optimization Questionnaire (M-TOQ) for acute migraine treatment. Finally, a treatment strategy and a follow-up plan have to be proposed. Guidelines for pharmacological and non-pharmacological treatments are presented in the second and third part of the recommendations.
Collapse
Affiliation(s)
- G Demarquay
- Neurological hospital, Lyon, Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, Lyon, France.
| | - X Moisset
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - M Lantéri-Minet
- Pain Department and FHU InovPain, CHU Nice - Côte Azur Université, Nice, France
| | - S de Gaalon
- Department of Neurology, Laënnec Hospital, CHU de Nantes, Nantes, France
| | - A Donnet
- Centre d'évaluation et de traitement de la douleur, FHU INOVPAIN, hôpital de La Timone, Marseille, France
| | - P Giraud
- Department of Neurology, Annecy Genevois Hospital, Annecy, France
| | | | - C Lucas
- Centre d'Evaluation et de Traitement de la Douleur, Service de Neurochirurgie, Hôpital Salengro, CHU de Lille, Lille, France
| | - J Mawet
- Emergency Headache Center (Centre d'Urgences Céphalées), Department of Neurology, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - C Roos
- Emergency Headache Center (Centre d'Urgences Céphalées), Department of Neurology, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - D Valade
- Department of Neurosurgery, Pitié-Sapêtrière Hospital, Paris, France
| | - A Ducros
- Department of Neurology, Gui de Chauliac Hospital, CHU Montpellier, University of Montpellier, 34000 Montpellier, France
| |
Collapse
|
13
|
Ducros A, de Gaalon S, Roos C, Donnet A, Giraud P, Guégan-Massardier E, Lantéri-Minet M, Lucas C, Mawet J, Moisset X, Valade D, Demarquay G. Revised guidelines of the French headache society for the diagnosis and management of migraine in adults. Part 2: Pharmacological treatment. Rev Neurol (Paris) 2021; 177:734-752. [PMID: 34340810 DOI: 10.1016/j.neurol.2021.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/21/2022]
Abstract
The French Headache Society proposes updated French guidelines for the management of migraine. This article presents the second part of the guidelines, which is focused on the pharmacological treatment of migraine, including both the acute treatment of attacks and the prophylaxis of episodic migraine as well as chronic migraine with and without medication overuse. The specific situations that can be encountered in women with migraine are also discussed, including pregnancy, menstrual migraine, contraception and hormonal replacement therapy.
Collapse
Affiliation(s)
- A Ducros
- Department of neurology, Gui-de-Chauliac hospital, CHU Montpellier, university of Montpellier, 34000 Montpellier, France
| | - S de Gaalon
- Department of neurology, Laënnec hospital, CHU de Nantes, Nantes, France
| | - C Roos
- Emergency headache center (centre d'urgences céphalées), department of neurology, Lariboisière hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - A Donnet
- Centre d'évaluation et de traitement de la douleur, FHU INOVPAIN, hôpital de La Timone, Marseille, France
| | - P Giraud
- Department of neurology, Annecy Genevois hospital, Annecy, France
| | | | - M Lantéri-Minet
- Pain department, FHU InovPain, CHU Nice Côte Azur université, Nice, France
| | - C Lucas
- Centre d'évaluation et de traitement de la douleur, service de neurochirurgie, hôpital Salengro, CHRU de Lille, Lille, France
| | - J Mawet
- Emergency headache center (centre d'urgences céphalées), department of neurology, Lariboisière hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - X Moisset
- Neuro-Dol, université Clermont Auvergne, CHU de Clermont-Ferrand, INSERM, Clermont-Ferrand, France
| | - D Valade
- Department of neurosurgery, hôpital Pitié-Sapêtrière, Paris, France
| | - G Demarquay
- Neurological hospital, Lyon, neuroscience research center (CRNL), INSERM U1028, CNRS UMR5292, Lyon, France.
| |
Collapse
|
14
|
Abstract
Background Medication overuse headache (MOH) is one of the highly disabling headache disorder and affects about 1% of the population of the world. It is associated with the development of headache for 15 days or more, with consumption of acute symptomatic medications for 10-15 days (depending on the class of drug, like, simple analgesics, triptans, and opioids) in a month, used for relief of headache for three or more months, in a known patient of primary headache disorder. Objective The aim of this study was to review the topic of MOH and present the details of this disorder with an emphasis on recent updates in the field of pathophysiology and treatment. Material and Methods Literature search was performed in the PubMed/MEDLINE and Cochrane database with appropriate keywords and relevant full-text articles were reviewed for writing this article. Results Over the years, the concept of MOH has evolved, although the exact pathophysiology is still being explored. In a susceptible individual interplay of genetics, change in pain pathways, changes in areas of the brain associated with the perception of pain, and changes in the neurotransmitters have been implicated. It has to be differentiated from other secondary chronic daily headache disorders, by a careful history, targeted examination, details of intake of medications. Treatment predominantly involves patient education, removal of the offending agent, and initiation of prophylactic medications for primary headache disorder in the outpatient or inpatient services. Conclusions MOH is a secondary headache disorder, which should be considered in any chronic headache patient. There are various pathophysiological mechanisms attributed to its development. Management includes educating the patients about the disorder, detoxification, and prophylactic therapy.
Collapse
Affiliation(s)
| | - Thomas Mathew
- Department of Neurology, St. Johns Medical College Hospital, Bengaluru, Karnataka, India
| | | |
Collapse
|
15
|
VanderPluym J, Gautreaux J, Burch R, Whitaker E, Roberts J, Turner DP, Gelfand AA. Evidence Regarding Medication Overuse Headache in Children and Adolescents: Protocol for a Systematic Review. Headache 2021; 60:171-177. [PMID: 31913513 DOI: 10.1111/head.13726] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This proposed systematic review will identify the existing evidence on medication-overuse headache in children and adolescents. BACKGROUND A number of medications have been shown to be effective for acute treatment of migraine in children and adolescents. However, patients may find they need to use their acute medications more frequently when migraine frequency is high. This has led to concern about their potential to develop medication-overuse headache. METHODS We will search PubMed, Embase, Web of Science, PsycINFO, and Cochrane databases from their inception to present time. We will also search conference proceedings of the last 4 scientific meetings of relevant societies and scan the reference lists of studies identified through the search. Study designs will include case series, cross-sectional, cohort, case-control, and interventional studies. Participants will include children and adolescents under 18 years of age with primary headache disorders. We aim to determine whether frequency of acute medication use is associated with headache frequency in children and adolescents. Outcomes of interest include: (1) headache frequency; (2) change in headache frequency, with time and in relationship to use of acute medications; and (3) headache-related disability. We will also review data addressing treatment/management of medication overuse or medication-overuse headache in children and adolescents. Relevant comparators will be withdrawal vs reduction of acute medication, initiation of preventive therapy vs no initiation with or without withdrawal of acute medication, and initiation of preventive therapy early vs late. Outcomes of interest include (1) days of acute medication use; (2) headache frequency; (3) change in headache frequency; and (4) headache-related disability. After screening for inclusion, 2 team members will independently review and extract relevant data, and any discrepancies will be resolved through discussion and arbitration. We will assess risk of bias using appropriate tools (Cochrane Risk of Bias for randomized controlled trials (RCT) and Newcastle-Ottawa Score for observational studies). Data will be summarized descriptively in text and tables. RESULTS This systematic review will provide an overview of the available evidence on medication-overuse headache in children and adolescents. CONCLUSIONS Findings from this review will aid clinicians by clarifying for them the current state of the evidence base, and will inform design of future research on this topic.
Collapse
Affiliation(s)
| | - Jessica Gautreaux
- Department of Neurology, Children's Hospital of New Orleans, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Rebecca Burch
- Brigham and Women's Hospital Department of Neurology, Graham Headache Center, Harvard Medical School, Boston, MA, USA
| | - Evans Whitaker
- Library Studies, University of California San Francisco, San Francisco, CA, USA
| | - Jason Roberts
- Headache Journal, Headache Editorial Office, Plymouth, MA, USA
| | - Dana P Turner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Amy A Gelfand
- Child & Adolescent Headache Program, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
16
|
The Evolution of Medication Overuse Headache: History, Pathophysiology and Clinical Update. CNS Drugs 2021; 35:545-565. [PMID: 34002347 DOI: 10.1007/s40263-021-00818-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Medication overuse headache (MOH), the development or worsening of chronic headache resulting from frequent and excessive intake of medications used for acute treatment of headache, is a common secondary headache disorder and is associated with significant personal and societal burdens. The plausible physiologic mechanism is that chronic exposure to acute care migraine treatment leads to suppression of endogenous antinociceptive systems, consequently facilitating the trigeminal nociceptive process via up-regulation of the calcitonin gene-related peptide (CGRP) system. Recognizing and preventing its development is an integral aspect of migraine management, as medication overuse is a modifiable risk factor in the progression from episodic to chronic migraine. Over the years, MOH has been difficult to treat and has generated much controversy. Ongoing debates exist over the diagnostic criteria and treatment strategies, particularly regarding the roles of formal detoxification and preventive treatment. The arrival of the anti-CGRP monoclonal antibodies has also challenged our views of MOH and its treatment. This review outlines the evolution of MOH diagnostic criteria, presents the current understanding of MOH pathogenesis and discusses the debates over its development and treatment. Data on the efficacy of anti-CGRP monoclonal antibodies in the setting of medication overuse is also presented. These results indicate that patients with medication overuse, who are treated with these new medications, may not need to be detoxified in order to treat MOH. In light of these developments, it is likely that in the future MOH will be more readily diagnosed and treatment will result in better outcomes.
Collapse
|
17
|
Abstract
PURPOSE OF REVIEW Medication overuse headache (MOH)is a disabling problem worldwide with areas of controversy regarding its cause. This article reviews the recent ideas regarding the development of this disorder and its effective management. RECENT FINDINGS It has been proposed that all acute migraine medications can lead to MOH, with differences in the propensity of different agents to cause the problem. Early data suggests that gepants, which are small-molecule calcitonin gene-related peptide antagonists used for the acute treatment of migraine, may be an exception. Recent studies show that practitioners and the general public are still largely unaware of the problem of medication overuse and its damaging effects. SUMMARY MOH is an accepted concept of an increase in headaches driven by the frequent administration of acute antimigraine drugs. The impressions of providers, and studies documenting the concept may be flawed. Although it is likely that MOH does occur, and restricting the amount of acute medications is necessary to prevent it, it is also possible that increasing amounts of acute medications are simply a reflection of poorly controlled headaches, rather than a cause. Objective markers need to be developed to identify those who have MOH, which does not include all with chronic migraine, and to use these markers in diagnosis and management, particularly in those patients where the frequent acute drugs might only be a reflection of frequent headaches, rather than a cause.
Collapse
|
18
|
Robbins MS, Victorio MC, Bailey M, Cook C, Garza I, Huff JS, Ready D, Schuster NM, Seidenwurm D, Seng E, Szperka C, Lee E, Villanueva R. Quality improvement in neurology: Headache Quality Measurement Set. Neurology 2020; 95:866-873. [PMID: 32967929 PMCID: PMC7713732 DOI: 10.1212/wnl.0000000000010634] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/14/2020] [Indexed: 01/03/2023] Open
Affiliation(s)
- Matthew S Robbins
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - M Cristina Victorio
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Mark Bailey
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Calli Cook
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Ivan Garza
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - J Stephen Huff
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Duren Ready
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Nathaniel M. Schuster
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - David Seidenwurm
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Elizabeth Seng
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Christina Szperka
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Erin Lee
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| | - Raissa Villanueva
- From the Department of Neurology (M.S.R.), Weill Cornell Medicine, New York, NY; NeuroDevelopmental Science Center (M.C.V.), Akron Children's Hospital, OH; University of Alabama at Birmingham (M.B.), Indian Springs, AL; Emory University (C.C.), School of Nursing, Healthcare, Atlanta, GA; Mayo Clinic (I.V.), Rochester, MN; University of Virginia Health System (J.S.H.), Charlottesville, VA; Baylor Scott & White (D.R.), Temple, TX; Department of Anesthesiology (N.M.S.), University of California San Diego Center for Pain Medicine, La Jolla, CA; Sutter Imaging (D.S.), Sacramento, CA; Albert Einstein College of Medicine and Yeshiva University (E.S.), Bronx, NY; Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania (C.S.), Philadelphia, PA; American Academy of Neurology (E.R.), Minneapolis, MN; and University of Rochester (R.V.), NY
| |
Collapse
|
19
|
Dodick DW, Doty EG, Aurora SK, Ruff DD, Stauffer VL, Jedynak J, Dong Y, Pearlman EM. Medication overuse in a subgroup analysis of phase 3 placebo-controlled studies of galcanezumab in the prevention of episodic and chronic migraine. Cephalalgia 2020; 41:340-352. [PMID: 33143451 DOI: 10.1177/0333102420966658] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Acute medication overuse is prevalent in patients with migraine. METHODS In three phase 3, double-blind, randomized, placebo-controlled studies, patients with episodic migraine (EVOLVE-1 and EVOLVE-2) or chronic migraine (REGAIN) were randomized 2:1:1 to monthly subcutaneous injections of placebo or galcanezumab 120 or 240 mg for 3 or 6 months. This subgroup analysis evaluated mean changes in the number of monthly migraine headache days in each treatment among patients with versus without baseline acute medication overuse via mixing modelling with repeated measures. RESULTS The percentages of patients with baseline medication overuse in placebo, galcanezumab 120-mg and 240-mg groups, respectively, were 19.4%, 17.3%, and 19.3% for EVOLVE-1/-2 (pooled; post hoc), and 63.4%, 64.3%, and 64.1% for REGAIN (a priori). Both galcanezumab doses demonstrated significant improvement compared with placebo for overall least squares mean change in monthly migraine headache days in patients with baseline medication overuse in both the episodic and chronic migraine studies (p ≤ 0.001). Furthermore, both galcanezumab doses reduced average monthly medication overuse rates compared to placebo (p < 0.001) in both patient populations with medication overuse at baseline. CONCLUSIONS Galcanezumab appears to be effective for the preventive treatment of episodic and chronic migraine in patients who overuse acute medications.Trial registration: ClinicalTrials.gov Identifiers: NCT02614183, NCT02614196, and NCT02614261.
Collapse
Affiliation(s)
| | - Erin G Doty
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Sheena K Aurora
- Impel Neuropharma, 201 Elliott Avenue West, Seattle, WA, USA
| | - Dustin D Ruff
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | | | - Jakub Jedynak
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Yan Dong
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Eric M Pearlman
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| |
Collapse
|
20
|
Moavero R, Stornelli M, Papetti L, Ursitti F, Ferilli MAN, Balestri M, Sforza G, Tarantino S, Vigevano F, Valeriani M. Medication Overuse Withdrawal in Children and Adolescents Does Not Always Improve Headache: A Cross-Sectional Study. Front Neurol 2020; 11:823. [PMID: 32973650 PMCID: PMC7466727 DOI: 10.3389/fneur.2020.00823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
Background: MOH can be diagnosed in subjects with headache occurring 15 days/month in association with a regular medication overuse, but its existence is not universally accepted. ICHD-3 redefined criteria for MOH, removing the criterion associating drug suspension with headache course. The aim of our study was to compare the rate of patients diagnosed with medication overuse headache (MOH) according to ICHD-2 and ICHD-3 criteria, to verify the degree of concordance. The secondary aim was to verify if drug withdrawal was really associated with pain relief. Methods: In this cross-sectional study, we retrospectively analyzed a sample of 400 patients followed for primary chronic headache at the Headache Center of Bambino Gesù Children's Hospital. We then selected those presenting with a history of medication overuse, and we applied both ICHD-2 and ICHD-3 criteria to verify in which patients the criteria would identify a clinical diagnosis of MOH. Results: We identified 42 subjects (10.5%) with MOH; 23 of them (55%) presented a relief of headache withdrawing drug overuse. Regarding the applicability of the ICHD-2 criteria, 43% of patients (18/42) fulfilled all criteria, while all ICHD-3 diagnostic criteria were satisfied in 76% of patients (32/42). Eighteen patients (43%) satisfied both ICHD-2 and ICHD-3 criteria, while 10 patients (24%) did not satisfy either diagnostic criterion. Conclusions: Our study suggests that in children and adolescents, withdrawing medication overuse is not always associated with a clinical benefit. Therefore, though allowing a MOH diagnosis in a higher rate of patients as compared to ICHD-2, the application of ICHD-3 criteria does not guarantee a true a causal relationship between medication overuse and headache worsening.
Collapse
Affiliation(s)
- Romina Moavero
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Maddalena Stornelli
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Laura Papetti
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabiana Ursitti
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Michela Ada Noris Ferilli
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Martina Balestri
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giorgia Sforza
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Samuela Tarantino
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Federico Vigevano
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Massimiliano Valeriani
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Center for Sensory Motor Interaction, Aalborg University, Aalborg, Denmark
| |
Collapse
|
21
|
Robbins MS, Victorio MCC, Bailey M, Cook C, Garza I, Huff JS, Ready D, Schuster NM, Seidenwurm D, Seng E, Szperka C, Lee E, Villanueva R. Quality Improvement in Neurology: Headache Quality Measurement Set. Headache 2020; 61:219-226. [PMID: 32965046 DOI: 10.1111/head.13988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - Mark Bailey
- University of Alabama at Birmingham, Indian Springs, AL
| | - Calli Cook
- Emory University, School of Nursing, Healthcare, Atlanta, GA
| | | | - J Stephen Huff
- University of Virginia Health System, Charlottesville, VA
| | | | - Nathaniel M Schuster
- University of California San Diego Center for Pain Medicine, Department of Anesthesiology, La Jolla, CA
| | | | - Elizabeth Seng
- Albert Einstein College of Medicine and Yeshiva University, Bronx, NY
| | - Christina Szperka
- Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Erin Lee
- American Academy of Neurology, Minneapolis, MN
| | | |
Collapse
|
22
|
Abstract
BACKGROUND AND AIMS Medication-overuse headache (MOH) is a common chronic headache caused by overuse of headache analgesics. It has similarities with substance dependence disorders. The treatment of choice for MOH is withdrawal of the offending analgesics. Behavioral brief intervention treatment using methods adapted from substance misuse settings is effective. Here we investigate the severity of analgesics dependence in MOH using the Severity of Dependence Scale (SDS), validate the SDS score against formal substance dependence diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) and examine whether the SDS predicts successful withdrawal. METHODS Representative recruitment from the general population; 60 MOH patients, 15 chronic headache patients without medication overuse and 25 population controls. Headaches were diagnosed using the International Classification of Headache Disorders, medication use was assessed and substance dependence classified according to the DSM-IV. The SDS was scored by interviewers blinded to patient group. Descriptive statistics were used and validity of the SDS score assessed against a substance dependence diagnosis using ROC analysis. RESULTS Sixty-two percent of MOH patients overused simple analgesics, 38% centrally acting analgesics (codeine, opiates, triptans). Fifty percent of MOH patients were classified as DSM-IV substance dependent. Centrally active medication and high SDS scores were associated with higher proportions of dependence. ROC analysis showed SDS scores accurately identified dependence (area under curve 88%). Lower SDS scores were associated with successful withdrawal (P = 0.004). CONCLUSIONS MOH has characteristics of substance dependence which should be taken into account when choosing treatment strategy. TRIAL REGISTRATION Based on data collected in previously reported randomized BIMOH trial (; in the present manuscript, Clinical trials registration number: NCT01314768). The present part, however, represents observational data and is not a treatment trial.
Collapse
|
23
|
Hershey AD, Oskoui M, Pringsheim T, Holler-Managan Y, Potrebic S, Billinghurst L, Gloss D, Licking N, Sowell M, Victorio MC, Gersz E, Vrijsen E, Zanitsch H, Yonker M, Mack K, Gelfand AA, Szperka CL, Powers SW. New Guidelines: Interpretation, Application and the Future. Headache 2020; 59:1133-1143. [PMID: 31529478 DOI: 10.1111/head.13629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Andrew D Hershey
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Maryam Oskoui
- Department of Pediatric and Neurology, McGill University, Montréal, Canada.,Department of Neurosurgery, McGill University, Montréal, Canada
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Yolanda Holler-Managan
- Department of Pediatrics (Neurology), Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sonja Potrebic
- Neurology Department, Southern California Permanente Medical Group, Kaiser, Los Angeles, CA, USA
| | - Lori Billinghurst
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - David Gloss
- Department of Neurology, Charleston Area Medical Center, Charleston, WV, USA
| | - Nicole Licking
- Department of Neuroscience and Spine, St. Anthony Hospital-Centura Health, Lakewood, CO, USA
| | - Michael Sowell
- University of Louisville Comprehensive Headache Program and University of Louisville Child Neurology Residency Program, Louisville, KY, USA
| | - M Cristina Victorio
- Division of Neurology, NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH, USA
| | | | | | | | - Marcy Yonker
- Division Neurology, Children's Hospital Colorado, Aurora, CO, USA
| | - Kenneth Mack
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Amy A Gelfand
- Department of Neurology, University of San Francisco, San Francisco, CA, USA
| | - Christina L Szperka
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Scott W Powers
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
24
|
Lau CI, Liu MN, Chen WH, Walsh V, Wang SJ. Clinical and biobehavioral perspectives: Is medication overuse headache a behavior of dependence? PROGRESS IN BRAIN RESEARCH 2020; 255:371-402. [PMID: 33008514 DOI: 10.1016/bs.pbr.2020.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/28/2020] [Accepted: 05/01/2020] [Indexed: 02/08/2023]
Abstract
Medication overuse headache (MOH), previously known as analgesic abuse headache or medication misuse headaches, is a common form of chronic headache disorder that has a detrimental impact on health and society. Although it has been widely accepted that overusing abortive medications is paradoxically the cause of MOH and drug discontinuation is the treatment of choice, ongoing debates exist as to whether drug consumption per se is the cause or consequence of headache chronification. Certain features in MOH such as their compulsive drug-seeking behavior, withdrawal headaches and high relapse rates share similarities with drug dependence, suggesting that there might be common underlying biological and psychobehavioral mechanisms. In this regard, this article will discuss the updated evidence and current debates on the possible biobehavioral overlap between MOH and drug dependence. To begin with, we will discuss whether MOH has characteristics of substance dependence based on standard psychiatry diagnostic criteria and other widely used dependence scales. Recent epidemiological studies underscoring common psychiatric comorbidities between the two disorders will also be presented. Although both demonstrate seemingly distinct personality traits, recent studies revealed similar decision-making impairment from a cognitive perspective, indicating the presence of a maladaptive reward system in both disorders. In addition, emerging imaging studies also support this notion by showing reversible morphological and functional brain changes related to the mesocorticolimbic reward circuitry in MOH, with a strong resemblance to those in addiction. Finally, an increased familial risk for drug dependence and genetic association with dopaminergic and drug dependence molecular pathways in MOH also support a possible link between MOH and addiction. Understanding the role of dependence in MOH will have a great impact on disease management as this will provide the missing piece of the puzzle in current therapeutic strategies.
Collapse
Affiliation(s)
- Chi Ieong Lau
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan; College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan; University Hospital, Taipa, Macau
| | - Mu-N Liu
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Neurology, Memory and Aging Centre, University of California, San Francisco, CA, United States
| | - Wei-Hung Chen
- Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Vincent Walsh
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Brain Research Center and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
25
|
Sacco S, Braschinsky M, Ducros A, Lampl C, Little P, van den Brink AM, Pozo-Rosich P, Reuter U, de la Torre ER, Sanchez Del Rio M, Sinclair AJ, Katsarava Z, Martelletti P. European headache federation consensus on the definition of resistant and refractory migraine : Developed with the endorsement of the European Migraine & Headache Alliance (EMHA). J Headache Pain 2020; 21:76. [PMID: 32546227 PMCID: PMC7296705 DOI: 10.1186/s10194-020-01130-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/25/2020] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Despite advances in the management of headache disorders, some patients with migraine do not experience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to create a basis to develop a better pathophysiological understanding and to support further therapeutic advances. MAIN BODY Definitions were established with a consensus process using the Delphi method. Patients with migraine with or without aura or with chronic migraine can be defined as having resistant migraine and refractory migraine according to previous preventative failures. Resistant migraine is defined by having failed at least 3 classes of migraine preventatives and suffer from at least 8 debilitating headache days per month for at least 3 consecutive months without improvement; definition can be based on review of medical charts. Refractory migraine is defined by having failed all of the available preventatives and suffer from at least 8 debilitating headache days per month for at least 6 consecutive months. Drug failure may include lack of efficacy or lack of tolerability. Debilitating headache is defined as headache causing serious impairment to conduct activities of daily living despite the use of pain-relief drugs with established efficacy at the recommended dose and taken early during the attack; failure of at least two different triptans is required. CONCLUSIONS We hope, that the updated EHF definition will be able to solve the conflicts that have limited the use of definitions which have been put forward in the past. Only with a widely accepted definition, progresses in difficult-to-treat migraine can be achieved. This new definition has also the aim to increase the understanding of the impact of the migraine as a disease with all of its social, legal and healthcare implications. It is the hope of the EHF Expert Consensus Group that the proposed criteria will stimulate further clinical, scientific and social attention to patients who suffer from migraine which is difficult-to-treat.
Collapse
Affiliation(s)
- Simona Sacco
- Neuroscience section - Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy. .,Regional Referral Headache Center of the Abruzzo region, ASL Avezzano-Sulmona-L'Aquila, L'Aquila, Italy.
| | - Mark Braschinsky
- Headache Clinic, Department of Neurology, Tartu University Clinics, Tartu, Estonia
| | - Anne Ducros
- Headache Unit, Neurology Department, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Christian Lampl
- Department of Neurology, Headache Medical Centre Linz, Hospital Barmherzige Brüder, Centre of Integrative Medicine (ZiAM) Ordensklinikum Linz, Linz, Austria
| | - Patrick Little
- European Migraine & Headache Alliance (EMHA), Hendrik Ido Ambacht, The Netherlands
| | - Antoinette Maassen van den Brink
- Division of Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Uwe Reuter
- Charité Universitätsmedizin Berlin, Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Alexandra J Sinclair
- Metabolic Neurology, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Zaza Katsarava
- Evangelical Hospital Unna, Unna, Germany.,Departmentof Neurology, University of Duisburg-Essen, Essen, Germany.,EVEX Medical Corporation, Tbilisi, Georgia.,IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Regional Referral Headache Center of the Lazio region, Sant'Andrea Hospital, Rome, Italy
| |
Collapse
|
26
|
Pellesi L, Guerzoni S, Baraldi C, Cainazzo MM, Pini LA, Bellei E. Identification of candidate proteomic markers in the serum of medication overuse headache patients: An exploratory study. Cephalalgia 2020; 40:1070-1078. [PMID: 32347744 DOI: 10.1177/0333102420921847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE OF THE STUDY The pathophysiological mechanism of medication overuse headache is uncertain; no distinctive markers have been described right now. The aim of this study was to conduct proteomic analyses on serum samples from patients with medication overuse headache and healthy individuals. Specifically, mono- (SDS-PAGE) and two-dimensional gel electrophoresis (2-DE) followed by liquid chromatography tandem mass spectrometry (LC-MS/MS) were used to evaluate changes in serum proteins. MAIN FINDINGS By SDS-PAGE, four over-expressed bands were revealed in patients, compared to controls. 2-DE combined with LC-MS/MS analysis allowed confirmation of some proteins preliminarily detected by SDS-PAGE: Hemopexin, alpha-1-acid glycoprotein 1, apolipoprotein A4 and haptoglobin. Moreover, other differential proteins were isolated, mostly increased in MOH patients: Alpha-1-antitrypsin, immunoglobulin heavy constant alpha 1, retinol binding protein and transthyretin. Only one protein, immunoglobulin kappa constant, was decreased in the patients' group. CONCLUSIONS The investigation of the serum proteome can offer a better understanding about biological mechanisms underlying medication overuse headache. Specifically, medication overuse headache shares some serum biochemical markers with chronic pain conditions. Further studies might uncover the relevance of these proteins in medication overuse headache.
Collapse
Affiliation(s)
- Lanfranco Pellesi
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Guerzoni
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Baraldi
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Michela Cainazzo
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Alberto Pini
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy.,Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Bellei
- Department of Surgery, Medicine, Dentistry and Morphological Science with Transplant Surgery, Oncology and Regenerative Medicine Relevance, Proteomic Lab, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
27
|
Vandenbussche N, Paemeleire K, Katsarava Z. The Many Faces of Medication-Overuse Headache in Clinical Practice. Headache 2020; 60:1021-1036. [PMID: 32232847 DOI: 10.1111/head.13785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/28/2020] [Indexed: 12/24/2022]
Abstract
The management of medication-overuse headache (MOH) is multifaceted and headache experts have different views on the optimal strategy to tackle this type of secondary headache. The purpose of this review is to provide an overview of the literature on the management of MOH, and to highlight important considerations in the clinical evaluation of the MOH patient. Managing MOH in clinical practice starts by evaluating the headache patient with medication overuse, determining the overused drug(s), assessing the impact of headaches on the patient and assessing comorbid conditions and disorders. Withdrawal of the overused medication is the cornerstone of treatment. An inpatient or outpatient setting is chosen based on the clinical profile of the patient. There is evidence for abrupt withdrawal combined with headache preventive treatment. Bridging therapy to bring relief to withdrawal headaches and/or symptoms should be offered. Education and motivational work through multidisciplinary assessment show benefits in sustaining withdrawal and preventing relapse. Although the reversal of chronic headache after cessation of overused acute medication has been noticed worldwide, different aspects of the management of MOH, such as complete or gradual withdrawal, or preventive treatment with or without withdrawal are still debated.
Collapse
Affiliation(s)
| | - Koen Paemeleire
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Zaza Katsarava
- Department of Neurology, University of Duisburg-Essen, Essen, Germany.,Department of Neurology, Evangelical Hospital Unna, Unna, Germany.,EVEX Medical Corporation, Tbilisi, GA, USA.,Sechenov University Moscow, Moscow, Russian Federation
| |
Collapse
|
28
|
Chong CD. Brain Structural and Functional Imaging Findings in Medication-Overuse Headache. Front Neurol 2020; 10:1336. [PMID: 32047470 PMCID: PMC6997335 DOI: 10.3389/fneur.2019.01336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/02/2019] [Indexed: 12/14/2022] Open
Abstract
This chapter overviews research neuroimaging findings of patients with medication-overuse headache (MOH). Results indicate; (i) correlations between neuropathology and medication-overuse; (ii) changes in brain morphology and cortical function; and (iii) brain recovery subsequent to withdrawal of medication that was overused. Results of this narrative review indicate exacerbated brain structural and functional changes in regions of the pain-matrix and in regions of the mesocortical-limbic circuit in patients with MOH compared to patients with migraine or compared to healthy controls. Modification of brain morphology as well as an association between brain recovery and medication withdrawal suggest that the MOH disease process involves state (brain modification) and trait-like (brain adaptation and recovery) neuromechanisms.
Collapse
|
29
|
Jeyagurunathan A, Abdin E, Vaingankar JA, Chua BY, Shafie S, Chang SHS, James L, Tan KB, Basu S, Chong SA, Subramaniam M. Prevalence and comorbidity of migraine headache: results from the Singapore Mental Health Study 2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:33-43. [PMID: 31456029 DOI: 10.1007/s00127-019-01755-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. Studies have revealed that those with migraine headache and coexisting psychiatric disorders have poorer treatment outcomes and increased disability. The study aims to establish the prevalence, correlates, and comorbidities of migraine headache among the multi-ethnic Asian population in Singapore. METHOD Data were extracted from the Singapore Mental Health Study 2016 (SMHS 2016), a cross-sectional epidemiological survey of a nationally representative sample. Face-to-face interviews were completed with 6126 participants between 2016 and 2017. The data relating to chronic medical conditions, psychiatric conditions, and 30-day functioning and disability were captured using the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0. RESULTS The lifetime prevalence for migraine headache in the Singapore general population was 8.2%. Malay ethnicity (versus Chinese), female gender (versus male), and diploma holders (versus university) were significantly more likely to experience migraine headache. Participants belonging to the older age group (65 years and above versus 18-34 years of age), and those who were economically inactive (versus employed) were less likely to experience migraine headache. The mean age of onset for migraine was 26.4 years (SD = 11.1). Poisson regression analyses showed that migraine headache was also significantly associated with psychiatric conditions such as major depressive disorder (MDD) (prevalence ratio (PR), 1.80; 95% CI, 1.25-2.58), bipolar disorder (BD) (PR, 3.55; 95% CI, 2.29-5.51), generalized anxiety disorder (GAD) (PR, 2.04; 95% CI, 1.12-3.69), obsessive compulsive disorder (OCD) (PR, 2.20; 95% CI, 1.49-3.26), and alcohol use disorder (AUD) (PR, 1.93; 95% CI, 1.20-3.08). Those with migraine headache were significantly associated with poor functioning and disability compared to those without migraine headache. CONCLUSIONS AND DISCUSSION Our study showed significant associations between migraine headache and psychiatric disorders, as well as with role functioning and disability. The findings of our study emphasise the need for screening for psychiatric comorbidity among those with migraine and the development of appropriate interventions for this group.
Collapse
Affiliation(s)
- Anitha Jeyagurunathan
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shi Hui Sherilyn Chang
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Lyn James
- Ministry of Health (MOH), Singapore, Singapore
| | | | - Sutapa Basu
- Early Psychosis Intervention Programme (EPIP), Department of Psychosis, IMH, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| |
Collapse
|
30
|
Yuan X, Jiang W, Ren X, Liu C, Pan Y, Zou J, Jiang X, Ji W, Li Y, Feng Z, Yao L, Wang Y. Predictors of relapse in patients with medication overuse headache in Shanghai: A retrospective study with a 6-month follow-up. J Clin Neurosci 2019; 70:33-36. [DOI: 10.1016/j.jocn.2019.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 08/02/2019] [Accepted: 09/04/2019] [Indexed: 01/03/2023]
|
31
|
Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain? J Neurol 2019; 266:3167-3170. [PMID: 31686187 DOI: 10.1007/s00415-019-09611-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Although chronic low back pain (CLBP) is one of the most common pain syndromes, up to now, clear pathophysiological causes or specific treatment options are missing. Medication-overuse has been associated with chronic headache, but never with CLBP. HYPOTHESIS Based on several similarities between CLBP and Medication-Overuse Headache (MOH), we hypothesized that medication-overuse might contribute to CLBP as well, maybe even as an own entity. Might there be something like Medication-Overuse Backpain (MOB)? METHODS We substantiate our hypothesis with a preliminary case-series analyzing five patients suffering from CLBP with a marked medication-overuse. In these patients, a stepwise analgesic withdrawal was recommended. RESULTS Within 6 months of recruitment, five patients fulfilled the inclusion criteria and successfully completed discontinuation of their medication. All patients reported noticeable pain relief, despite the discontinuation of their analgesics. Withdrawal was well tolerated in all cases. CONCLUSIONS Considering our results, the described withdrawal method seems to be a simple and safe method to achieve pain reduction while simultaneously preventing organ damage. Despite the preliminary character of our results, our hypothesis might stimulate a new understanding of CLBP's pathophysiology.
Collapse
|
32
|
Gottschalk CH. Cognitive Biases & Errors in Headache Medicine. Headache 2019; 59:1863-1870. [DOI: 10.1111/head.13686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2019] [Indexed: 11/27/2022]
|
33
|
Viana M, De Icco R, Allena M, Sances G, Højland JR, Katsarava Z, Lainez MJA, Fadic R, Goicochea MT, Nappi G, Tassorelli C, Sandrini G, Guaschino E, Ghiotto N, Munksgaard SB, Rapsch M, Lopez B, Cerquetti D, Shand B, Osa M, Stoppini A. Clinical Subtypes of Medication Overuse Headache – Findings From a Large Cohort. Headache 2019; 59:1481-1491. [DOI: 10.1111/head.13641] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Michele Viana
- Headache Science Center IRCCS Mondino Foundation Pavia Italy
- Neurocenter of Southern Switzerland (NSI), Headache Center Regional Hospital Lugano Lugano Switzerland
- Headache Group, Department of Basic and Clinical Neurosciences King's College London London UK
| | - Roberto De Icco
- Headache Science Center IRCCS Mondino Foundation Pavia Italy
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
| | - Marta Allena
- Headache Science Center IRCCS Mondino Foundation Pavia Italy
| | - Grazia Sances
- Headache Science Center IRCCS Mondino Foundation Pavia Italy
| | | | - Zaza Katsarava
- Department of Neurology University of Duisburg‐Essen Essen Germany
- Department of Neurology Evangelical Hospital Unna Unna Germany
- EVEX Medical Corporation Tbilisi GA USA
- Sechenov University Moscow Moscow Russian Federation
| | - Miguel J. A. Lainez
- Foundation of the Valencian Community University Clinical Hospital Valencia Spain
| | - Ricardo Fadic
- Department of Neurology Pontificia Universidad Católica de Chile Santiago Chile
| | | | - Giuseppe Nappi
- Headache Science Center IRCCS Mondino Foundation Pavia Italy
| | - Cristina Tassorelli
- Headache Science Center IRCCS Mondino Foundation Pavia Italy
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Abstract
This article outlines key features of diagnosis and treatment of migraine in children and adolescents. It emphasizes techniques that can be used by clinicians to optimize history taking in this population, as well as recognition of episodic conditions that may be associated with migraine and present in childhood. Acute treatment strategies include use of over-the-counter analgesics and triptan medications that have been approved by the US Food and Drug Administration for use in children and adolescents. Preventive treatment approach includes lifestyle modifications, behavioral strategies, and consideration of preventive medications with the lowest side effect profiles.
Collapse
Affiliation(s)
- Kaitlin Greene
- Department of Neurology, UCSF Pediatric Headache Center, University of California, San Francisco, UCSF Benioff Children's Hospital, Mission Hall Box 0137, 550 16th Street, 4th Floor, San Francisco, CA 94158, USA
| | - Samantha L Irwin
- Department of Neurology, UCSF Pediatric Headache Center, University of California, San Francisco, UCSF Benioff Children's Hospital, Mission Hall Box 0137, 550 16th Street, 4th Floor, San Francisco, CA 94158, USA
| | - Amy A Gelfand
- Department of Neurology, UCSF Pediatric Headache Center, University of California, San Francisco, UCSF Benioff Children's Hospital, Mission Hall Box 0137, 550 16th Street, 4th Floor, San Francisco, CA 94158, USA.
| |
Collapse
|
35
|
Loder EW, Scher AI. Medication overuse headache: The trouble with prevalence estimates. Cephalalgia 2019; 40:3-5. [PMID: 31522548 DOI: 10.1177/0333102419876907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Elizabeth W Loder
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ann I Scher
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, USA
| |
Collapse
|
36
|
Chen PK, Wang SJ. Medication Overuse and Medication Overuse Headache: Risk Factors, Comorbidities, Associated Burdens and Nonpharmacologic and Pharmacologic Treatment Approaches. Curr Pain Headache Rep 2019; 23:60. [DOI: 10.1007/s11916-019-0796-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
37
|
Munksgaard SB, Madsen SK, Wienecke T. Treatment of medication overuse headache-A review. Acta Neurol Scand 2019; 139:405-414. [PMID: 30710346 DOI: 10.1111/ane.13074] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 01/10/2019] [Accepted: 01/29/2019] [Indexed: 12/19/2022]
Abstract
Medication overuse headache (MOH) is the most prevalent chronic headache disorder with a prevalence between 1% and 2% worldwide. The disease has been acknowledged for almost 30 years, yet experts still disagree on how best to treat MOH. By performing a search in PubMed on the terms "medication overuse headache," "analgesics abuse headache," "rebound headache," "drug induced headache," and "headache AND drug misuse" limited to human studies published in English between January 1, 2004, and November 1, 2017, we aimed to evaluate current literature concerning predictors of treatment outcome, inpatient and outpatient treatment programs, initial versus latent administration of prophylactic medications, and to review the effect of prophylactic medications. Selection criteria were prospective, comparative, or controlled trials on treatment of MOH in persons of at least 18 years of age. Several studies evaluated risk factors to predict the outcome of MOH treatment, but many studies were underpowered. Psychiatric comorbidity, high dependence score, and overuse of barbiturates, benzodiazepines, and opioids predicted a poorer outcome of withdrawal therapy. Patients with these risk factors benefit from inpatient treatment, whereas patients without risk factors benefit equally from inpatient and outpatient treatment. Some medications for migraine prophylactics have shown better effect on MOH compared with placebo, but not when combined with withdrawal. We conclude that detoxification programs are of great importance in MOH treatment. Latent administration of prophylactic medications reduces the number of patients needing prophylactic medication. Individualizing treatment according to the predictors of outcome may improve treatment outcome and thus reduce work-related and treatment-related costs.
Collapse
Affiliation(s)
- Signe B. Munksgaard
- Danish Headache Center, Department of Neurology Rigshospitalet‐Glostrup Glostrup Denmark
- Neurovascular Center, Department of Neurology Zealand University Hospital Roskilde Denmark
| | - Samuel K. Madsen
- Danish Headache Center, Department of Neurology Rigshospitalet‐Glostrup Glostrup Denmark
- Neurovascular Center, Department of Neurology Zealand University Hospital Roskilde Denmark
| | - Troels Wienecke
- Danish Headache Center, Department of Neurology Rigshospitalet‐Glostrup Glostrup Denmark
- Neurovascular Center, Department of Neurology Zealand University Hospital Roskilde Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| |
Collapse
|
38
|
Tepper SJ, Diener HC, Ashina M, Brandes JL, Friedman DI, Reuter U, Cheng S, Nilsen J, Leonardi DK, Lenz RA, Mikol DD. Erenumab in chronic migraine with medication overuse: Subgroup analysis of a randomized trial. Neurology 2019; 92:e2309-e2320. [PMID: 30996056 PMCID: PMC6598821 DOI: 10.1212/wnl.0000000000007497] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 01/16/2019] [Indexed: 01/03/2023] Open
Abstract
Objective To determine the effect of erenumab, a human anti-calcitonin gene-related peptide receptor monoclonal antibody, in patients with chronic migraine and medication overuse. Methods In this double-blind, placebo-controlled study, 667 adults with chronic migraine were randomized (3:2:2) to placebo or erenumab (70 or 140 mg), stratified by region and medication overuse status. Data from patients with baseline medication overuse at baseline were used to assess changes in monthly migraine days, acute migraine-specific medication treatment days, and proportion of patients achieving ≥50% reduction from baseline in monthly migraine days. Results Of 667 patients randomized, 41% (n = 274) met medication overuse criteria. In the medication overuse subgroup, erenumab 70 or 140 mg groups had greater reductions than the placebo group at month 3 in monthly migraine days (mean [95% confidence interval] −6.6 [−8.0 to −5.3] and −6.6 [−8.0 to −5.3] vs −3.5 [−4.6 to −2.4]) and acute migraine-specific medication treatment days (−5.4 [−6.5 to −4.4] and −4.9 [−6.0 to −3.8] vs −2.1 [−3.0 to −1.2]). In the placebo and 70 and 140 mg groups, ≥50% reductions in monthly migraine days were achieved by 18%, 36% (odds ratio [95% confidence interval] 2.67 [1.36–5.22]) and 35% (odds ratio 2.51 [1.28–4.94]). These clinical responses paralleled improvements in patient-reported outcomes with a consistent benefit of erenumab across multiple measures of impact, disability, and health-related quality of life. The observed treatment effects were similar in the non–medication overuse subgroup. Conclusions Erenumab reduced migraine frequency and acute migraine-specific medication treatment days in patients with chronic migraine and medication overuse, improving disability and quality of life. Clinicaltrials.gov identifier NCT02066415. Classification of evidence This study provides Class II evidence that erenumab reduces monthly migraine days at 3 months in patients with chronic migraine and medication overuse.
Collapse
Affiliation(s)
- Stewart J Tepper
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA.
| | - Hans-Christoph Diener
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Messoud Ashina
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Jan Lewis Brandes
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Deborah I Friedman
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Uwe Reuter
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Sunfa Cheng
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Jon Nilsen
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Dean K Leonardi
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Robert A Lenz
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| | - Daniel D Mikol
- From the Geisel School of Medicine at Dartmouth (S.J.T.), Hanover, NH; Department of Neurology (H.-C.D.), University of Duisburg-Essen, Germany; Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology (J.L.B.), Vanderbilt University School of Medicine; Nashville Neuroscience Group (J.L.B.), TN; Neurology and Neurotherapeutics and Ophthalmology (D.I.F.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; and Amgen Inc (S.C., J.N., D.K.L., R.A.L., D.D.M.), Thousand Oaks, CA
| |
Collapse
|
39
|
|
40
|
Abstract
Migraine and tension-type headache are highly prevalent. Migraine is associated with significant work- and family-related disability. Migraine is underdiagnosed; it reasonable to err on the side of migraine when choosing between primary headaches. Barriers to appropriate treatment of migraine include lack of access to providers, misdiagnosis, and acute and preventive therapies not being prescribed. Acute, rescue, and preventive treatment options are extensive, and new classes of treatments are either available or in development. This review addresses diagnostic challenges including recognizing migraine with aura. It also summarizes nonpharmacologic, acute, rescue, and preventive treatment options for migraine and treatment of tension-type headache.
Collapse
Affiliation(s)
- Rebecca Burch
- Department of Neurology, John R. Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, 1153 Centre Street, Suite 4H, Jamaica Plain, MA 02130, USA.
| |
Collapse
|
41
|
Loder E, Rizzoli P. Pharmacologic Prevention of Migraine: A Narrative Review of the State of the Art in 2018. Headache 2018; 58 Suppl 3:218-229. [DOI: 10.1111/head.13375] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2018] [Indexed: 02/01/2023]
Affiliation(s)
- Elizabeth Loder
- Division of Headache; Brigham and Women’s Hospital; Boston MA USA
- Department of Neurology; Harvard Medical School; Boston MA USA
| | - Paul Rizzoli
- Department of Neurology; Harvard Medical School; Boston MA USA
- Graham Headache Center; Brigham and Women’s Hospital; Boston MA USA
| |
Collapse
|
42
|
Scaratti C, Covelli V, Guastafierro E, Leonardi M, Grazzi L, Rizzoli PB, D’Amico D, Raggi A. A Qualitative Study On Patients With Chronic Migraine With Medication Overuse Headache: Comparing Frequent And Non-Frequent Relapsers. Headache 2018; 58:1373-1388. [DOI: 10.1111/head.13385] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Chiara Scaratti
- Public Health and Disability Unit, Neurological Institute “C. Besta” IRCCS Foundation; Neurology Milan Italy
| | | | - Erika Guastafierro
- Public Health and Disability Unit, Neurological Institute “C. Besta” IRCCS Foundation; Neurology Milan Italy
| | - Matilde Leonardi
- Public Health and Disability Unit, Neurological Institute “C. Besta” IRCCS Foundation; Neurology Milan Italy
| | - Licia Grazzi
- Headache and Neuroalgology Unit; Neurological Institute “C. Besta” IRCCS Foundation; Milan Italy
| | - Paul B. Rizzoli
- John R. Graham Headache Center, Department of Neurology; Brigham and Women's Faulkner Hospital; Boston MA USA
| | - Domenico D’Amico
- Headache and Neuroalgology Unit; Neurological Institute “C. Besta” IRCCS Foundation; Milan Italy
| | - Alberto Raggi
- Public Health and Disability Unit, Neurological Institute “C. Besta” IRCCS Foundation; Neurology Milan Italy
| |
Collapse
|
43
|
Neurophysiological correlates of clinical improvement after greater occipital nerve (GON) block in chronic migraine: relevance for chronic migraine pathophysiology. J Headache Pain 2018; 19:73. [PMID: 30128946 PMCID: PMC6102162 DOI: 10.1186/s10194-018-0901-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 08/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Therapeutic management of Chronic Migraine (CM), often associated with Medication Overuse Headache (MOH), is chiefly empirical, as no biomarker predicting or correlating with clinical efficacy is available to address therapeutic choices. The present study searched for neurophysiological correlates of Greater Occipital Nerve Block (GON-B) effects in CM. METHODS We recruited 17 CM women, of whom 12 with MOH, and 19 healthy volunteers (HV). Patients had no preventive treatment since at least 3 months. After a 30-day baseline, they received a bilateral betamethasone-lidocaine GON-B of which the therapeutic effect was assessed 1 month later. Habituation of visual evoked potentials (VEP) and intensity dependence of auditory evoked potentials (IDAP) were recorded before and 1 week after the GON-B. RESULTS At baseline, CM patients had a VEP habituation not different from HV, but a steeper IDAP value than HV (p = 0.01), suggestive of a lower serotonergic tone. GON-B significantly reduced the number of total headache days per month (- 34.9%; p = 0.003). Eight out 17CM patients reversed to episodic migraine and medication overuse resolved in 11 out of 12 patients. One week after the GON-B VEP habituation became lacking respect to baseline (p = 0.01) and to that of HV (p = 0.02) like in episodic migraine, while the IDAP slope significantly flattened (p < 0.0001). GON-B-induced reduction in headache days positively correlated with IDAP slope decrease (rho = 0.51, p = 0.03). CONCLUSIONS GON-B may be effective in the treatment of CM, with or without MOH. The pre-treatment IDAP increase is compatible with a weak central serotonergic tone, which is strengthened after GON-B, suggesting that serotonergic mechanisms may play a role in CM and its reversion to episodic migraine. Since the degree of post-treatment IDAP decrease is correlated with clinical improvement, IDAP might be potentially useful as an early predictor of GON-B efficacy.
Collapse
|
44
|
Orr SL, Kabbouche MA, O’Brien HL, Kacperski J, Powers SW, Hershey AD. Paediatric migraine: evidence-based management and future directions. Nat Rev Neurol 2018; 14:515-527. [DOI: 10.1038/s41582-018-0042-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
45
|
Vandenbussche N, Laterza D, Lisicki M, Lloyd J, Lupi C, Tischler H, Toom K, Vandervorst F, Quintana S, Paemeleire K, Katsarava Z. Medication-overuse headache: a widely recognized entity amidst ongoing debate. J Headache Pain 2018; 19:50. [PMID: 30003412 PMCID: PMC6043466 DOI: 10.1186/s10194-018-0875-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/13/2018] [Indexed: 12/30/2022] Open
Abstract
Medication overuse in primary headache disorders is a worldwide phenomenon and has a role in the chronification of headache disorders. The burden of disease on individuals and societies is significant due to high costs and comorbidities. In the Third Edition of the International Classification of Headache Disorders, medication-overuse headache is recognized as a separate secondary entity next to mostly primary headache disorders, although many clinicians see the disease as a sole complication of primary headache disorders. In this review, we explore the historical background of medication-overuse headache, its epidemiology, phenomenology, pathophysiology and treatment options. The review explores relevant unanswered questions and summarizes the current debates in medication-overuse headache.
Collapse
Affiliation(s)
- Nicolas Vandenbussche
- Headache Group, Department of Basic and Clinical Neuroscience, King’s College London, and NIHR-Wellcome Trust King’s Clinical Research Facility, King’s College Hospital, Denmark Hill, London, SE5 9PJ UK
| | - Domenico Laterza
- Department of Neuroscience, St. Agostino Estense Hospital, University of Modena and Reggio Emilia, via P. Giardini 1355, 41100 Modena, Italy
| | - Marco Lisicki
- Headache Research Unit, Université de Liège, Liège, Belgium
| | - Joseph Lloyd
- Headache Research-Wolfson CARD, King’s College London, London, UK
| | - Chiara Lupi
- Headache Centre, Careggi University Hospital, Health Sciences Department, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - Hannes Tischler
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Kati Toom
- Department of Neurology, Tartu University Clinics, Tartu, Estonia
- Estonian Headache Society, Tartu, Estonia
| | | | - Simone Quintana
- Headache Center, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Koen Paemeleire
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Zaza Katsarava
- Evangelical Hospital Unna and University of Duisburg-Essen, Duisburg, Germany
| |
Collapse
|
46
|
Shan CS, Xu QQ, Shi YH, Wang Y, He ZX, Zheng GQ. Chuanxiong Formulae for Migraine: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials. Front Pharmacol 2018; 9:589. [PMID: 30013473 PMCID: PMC6036270 DOI: 10.3389/fphar.2018.00589] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/16/2018] [Indexed: 12/25/2022] Open
Abstract
Objective: Migraine is a complex, prevalent and disabling neurological disorder characterized by recurrent episodes of headache without ideal treatment. We aim to assess the current available evidence of herbal Chuanxiong (Ligusticum chuanxiong Hort. root) formulae for the treatment of migraine according to the high-quality randomized controlled trials (RCTs). Methods: English and Chinese electronic databases were searched from their inceptions until March 2017. The methodological quality of included study was assessed by the Cochrane Collaboration risk of bias tool. RCTs with Cochrane risk of bias (RoB) score ≥4 were included in the analyses. Meta-analysis was conducted using RevMan 5.3 software. Publication bias was assessed by funnel plot analysis and Egger's test. Results: Nineteen RCTs with 1832 participants were identified. The studies investigated the Chuanxiong formulae vs. placebo (n = 5), Chuanxiong formulae vs. conventional pharmacotherapy (CP) (n = 13 with 15 comparisons), and Chuanxiong formulae plus CP vs. CP (n = 1). Meta-analysis indicated that Chuanxiong formulae could reduce frequency, duration, days and pain severity of migraine and improve the total clinical efficacy rate (P < 0.05). Adverse event monitoring was reported in 16 out of 19 studies and occurrence rate of adverse event was low. Conclusion: The findings of present study indicated that Chuanxiong formulae exerted the symptom reliefs of for migraine.
Collapse
Affiliation(s)
- Chun-Shuo Shan
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qing-Qing Xu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi-Hua Shi
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yong Wang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhang-Xin He
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guo-Qing Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
47
|
Rizzoli PB. What the pharmacological management of migraine can tell us about the future of migraine patient care. Neurol Sci 2018; 39:39-45. [PMID: 29904832 DOI: 10.1007/s10072-018-3338-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Some of the principles of the pharmacologic management of migraine are echoed in urgent discussions of the future of headache care in the USA and around the world. From adverse events to tolerance, addiction, medication overuse and medication persistence, solutions to the pathophysiologic puzzles, and management difficulties in migraine can be found by paying closer attention to patient reports and by facilitating greater patient involvement in the treatment process. Similarly, listening to the patient as customer in the process of value-based care, so adaptable for the problem of migraine, is the solution to the health care crisis we face in so many countries.
Collapse
Affiliation(s)
- Paul B Rizzoli
- Department of Neurology, John R. Graham Headache Center, Harvard Medical School, Brigham and Women's/Faulkner Hospital, 1153 Centre Street, Suite 4H, Boston, MA, 02130, USA.
| |
Collapse
|
48
|
Diener HC, Holle D, Dresler T, Gaul C. Chronic Headache Due to Overuse of Analgesics and Anti-Migraine Agents. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:365-370. [PMID: 29932046 PMCID: PMC6039717 DOI: 10.3238/arztebl.2018.0365] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 10/30/2017] [Accepted: 03/15/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND The frequent or regular use of analgesics and anti-migraine drugs can make headache more frequent and induce the transformation of episodic to chronic headache. Chronic headache due to medication overuse is defined as headache that is present on ≥ 15 days per month for at least three months in a patient who previously suffered from primary headaches, and who takes analgesics on ≥ 15 days per month or anti-migraine drugs (triptans or ergot alkaloids), opioid drugs, or combined analgesics on ≥ 10 days per month. METHODS This review is based on pertinent articles published up to December 2017 that were retrieved by a selective search in PubMed employing the terms "medication overuse AND headache" and "medication overuse headache." RESULTS The prevalence of medication overuse headache in the general population in Germany is 0.7% -1%. This disorder is more common in women and in persons suffering from comorbid mental disorders or other painful conditions. The treatment of medication overuse headache consists of three steps. Patient education and counseling are given with the goal of reducing the intake of medication for acute headache treatment. The ensuing headache prophylaxis is with topiramate, amitriptyline, or onabotulinum toxin A. If these treatment strategies fail, a drug holiday is recommended. This can be in the outpatient, day clinic, or inpatient setting, depending on the severity of the condition and its comorbidities. CONCLUSION Patients who frequently take acute medication to treat headache episodes must be identified early in order to avoid headache chronification and medication overuse headache. The suggested treatment algorithm is still in need of validation by randomized trials.
Collapse
Affiliation(s)
| | - Dagny Holle
- Department of Neurology and West German Headache Center, Essen
| | - Thomas Dresler
- Department of Psychiatry and Psychotherapy, University Hospital and Faculty of Medicine, Tübingen LEAD Graduate School & Research Network, University of Tübingen
| | | |
Collapse
|
49
|
Abstract
Headache, an almost universal human experience, is one of the most common complaints encountered in medicine and neurology. Described and categorized since antiquity, with the first classification by Aretaeus of Cappadocia, other classifications followed. The evaluation of this condition may be straightforward or challenging, and, though often benign, headache may prove to be an ominous symptom. This review discusses the current diagnosis and classification of headache disorders and principles of management, with a focus on migraine, tension-type headache, trigeminal autonomic cephalgias, and various types of daily headache.
Collapse
Affiliation(s)
- Paul Rizzoli
- Graham Headache Center, Brigham and Women's Faulkner Hospital, Harvard Medical School, Boston, Mass
| | - William J Mullally
- Graham Headache Center, Brigham and Women's Faulkner Hospital, Harvard Medical School, Boston, Mass.
| |
Collapse
|
50
|
Chen Z, Chen X, Chen Z, Liu M, He H, Ma L, Yu S. Alteration of gray matter texture features over the whole brain in medication-overuse headache using a 3-dimentional texture analysis. J Headache Pain 2017; 18:112. [PMID: 29285575 PMCID: PMC5745370 DOI: 10.1186/s10194-017-0820-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/13/2017] [Indexed: 02/07/2023] Open
Abstract
Background Imaging studies have provided valuable information in understanding the headache neuromechanism for medication-overuse headache (MOH), and the aim of this study is to investigate altered texture features of MR structural images over the whole brain in MOH using a 3-dimentional texture analysis. Methods Brain three-dimensional T1-weighted structural images were obtained from 44 MOH patients and 32 normal controls (NC). The imaging processing included two steps: gray matter (gray images) segment and a 3-dimensional texture features mapping. Voxel-based gray-level co-occurrence matrix (VGLCM) was performed to measure the texture parameters mapping including Contrast, Correlation, Energy, Entropy and inverse difference moment (IDM). Results The texture parameters of increased Contrast and Entropy, decreased Energy and IDM were identified in cerebellar vermis of MOH patients compared to NCs. Increased Contrast and decreased Energy were found in left cerebellum. Increased Correlation located in left dorsolateral periaqueductal gray (L-dlPAG), right parahippocampal gyrus (R-PHG), and left middle frontal gyrus (L-MFG) and decreased Correlation located in right superior parietal lobule(R-SPL). Disease duration was positively correlated with Contrast of vermis and negatively correlated with Correlation of R-SPL.HAMD score was negatively correlated with Correlation of R-PHG. MoCA score was positively correlated with Correlation of R-SPL. Conclusion The altered textures in gray matter related to pain discrimination and modulation, affective and cognitive processing were helpful in understanding the pathogenesis of MOH. Texture analysis using VGLCM is a sensitive and efficient method to detect subtle gray matter changes in MOH. Electronic supplementary material The online version of this article (10.1186/s10194-017-0820-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Zhiye Chen
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Beijing, 100853, China.,Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhiqiang Chen
- Research Center for Brain Inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.,University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Mengqi Liu
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Beijing, 100853, China
| | - Huiguang He
- Research Center for Brain Inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. .,University of Chinese Academy of Sciences, Beijing, 100190, China. .,Center for Excellence in Brain Science and Intelligence Technology, Beijing, 100190, China.
| | - Lin Ma
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China.
| |
Collapse
|