Reference : Orbitofrontal cortex involvement in chronic analgesic-overuse headache evolving from ...
Scientific journals : Article
Social & behavioral sciences, psychology : Neurosciences & behavior
Human health sciences : Neurology
Orbitofrontal cortex involvement in chronic analgesic-overuse headache evolving from episodic migraine
Fumal, Arnaud mailto [Centre Hospitalier Universitaire de Liège - CHU > > Neurologie CHR >]
Laureys, Steven mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron]
Di Clemente, Laura [> > > >]
Boly, Mélanie mailto [Université de Liège - ULiège > > Neurologie >]
Bohotin, Valentin [> > > >]
Vandenheede, Michel [> >]
Coppola, Gianluca [> > > >]
Salmon, Eric mailto [Université de Liège - ULiège > Département des sciences cliniques > Neuroimagerie des troubles de la mémoire et révalid. cogn. >]
Kupers, Ron [> > > >]
Schoenen, Jean mailto [Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Neuro-anatomie]
Oxford Univ Press
Pt 2
Yes (verified by ORBi)
[en] PET ; orbitofrontal cortex ; migraine ; addiction ; medication overuse headache
[en] The way in which medication overuse transforms episodic migraine into chronic daily headache is unknown. To search for candidate brain areas involved in this process, we measured glucose metabolism with 18-FDG PET in 16 chronic migraineurs with analgesic overuse before and 3 weeks after medication withdrawal and compared the data with those of a control population (n = 68). Before withdrawal, the bilateral thalamus, orbitofrontal cortex (OFC), anterior cingulate gyrus, insula/ventral striatum and right inferior parietal lobule were hypometabolic, while the cerebellar vermis was hypermetabolic. All dysmetabolic areas recovered to almost normal glucose uptake after withdrawal of analgesics, except the OFC where a further metabolic decrease was found. A subanalysis showed that most of the orbitofrontal hypometabolism was due to eight patients overusing combination analgesics and/or an ergotamine-caffeine preparation. Medication overuse headache is thus associated with reversible metabolic changes in pain processing structures like other chronic pain disorders, but also with persistent orbitofrontal hypofunction. The latter is known to occur in drug dependence and could predispose subgroups of migraineurs to recurrent analgesic overuse.

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