Chanraud S, Di Scala G, Dilharreguy B, Schoenen J, Allard M, Radat F
Bordeaux University, CNRS, INCIA, France EPHE, France
Bordeaux University, CNRS, INCIA, France.
Cephalalgia. 2014 Jul;34(8):605-15. doi: 10.1177/0333102413519514. Epub 2014 Jan 21.
Several imaging studies have identified localized anatomical and functional brain changes in medication-overuse headache (MOH).
The objective of this article is to evaluate whole-brain functional connectivity at rest together with voxel-based morphometry in MOH patients, in comparison with episodic migraine (EM) patients and healthy controls (HCs).
Anatomical MRI and resting-state functional MRI scans were obtained in MOH patients (n = 17 and 9, respectively), EM patients (n = 18 and 15, respectively) and HCs (n = 17 and 17). SPM8 was used to analyze voxel-based morphometry and seed (left precuneus) to voxel connectivity data in the whole brain.
Functional connectivity at rest was altered in MOH patients. Connectivity was decreased between precuneus and regions of the default-mode network (frontal and parietal cortices), but increased between precuneus and hippocampal/temporal areas. These functional modifications were not accompanied by significant gross morphological changes. Furthermore, connectivity between precuneus and frontal areas in MOH was negatively correlated with migraine duration and positively correlated with self-evaluation of medication dependence. Gray matter volumes of frontal regions, precuneus and hippocampus were also negatively related to migraine duration. Functional connectivity within the default-mode network appeared to predict anxiety scores of MOH patients while gray matter volumes in this network predicted their depression scores.
Our data suggest that MOH is associated with functional alterations within intrinsic brain networks rather than with macrostructural changes. They also support the view that dependence-related processes might play a prominent role in its development and maintenance.
多项影像学研究已确定药物过量使用性头痛（MOH）存在局部脑解剖结构和功能改变。
本文旨在评估MOH患者静息状态下的全脑功能连接以及基于体素的形态学，与发作性偏头痛（EM）患者和健康对照（HC）进行比较。
对MOH患者（分别为n = 17和9）、EM患者（分别为n = 18和15）和HC（n = 17和17）进行解剖MRI和静息态功能MRI扫描。使用SPM8分析全脑基于体素的形态学以及种子点（左楔前叶）到体素的连接性数据。
MOH患者静息状态下的功能连接发生改变。楔前叶与默认模式网络区域（额叶和顶叶皮质）之间的连接性降低，但楔前叶与海马体/颞叶区域之间的连接性增加。这些功能改变并未伴有明显的大体形态学变化。此外，MOH患者楔前叶与额叶区域之间的连接性与偏头痛持续时间呈负相关，与药物依赖的自我评估呈正相关。额叶区域、楔前叶和海马体的灰质体积也与偏头痛持续时间呈负相关。默认模式网络内的功能连接似乎可预测MOH患者的焦虑评分，而该网络中的灰质体积可预测其抑郁评分。
我们的数据表明，MOH与脑内固有网络的功能改变有关，而非宏观结构变化。它们还支持这样一种观点，即与依赖相关的过程可能在其发展和维持中起重要作用。
