Schwedt Todd J, Chong Catherine D
Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, USA.
Headache. 2017 Jul;57(7):1173-1178. doi: 10.1111/head.13037. Epub 2017 Feb 3.
Research imaging of brain structure and function has helped to elucidate the pathophysiology of medication overuse headache (MOH).
This is a narrative review of imaging research studies that have investigated brain structural and functional alterations associated with MOH. Studies included in this review have investigated abnormal structure and function of pain processing regions in people with MOH, functional patterns that might predispose individuals to development of MOH, similarity of brain functional patterns in patients with MOH to those found in people with addiction, brain structure that could predict headache improvement following discontinuation of the overused medication, and changes in brain structure and function after discontinuation of medication overuse.
MOH is associated with atypical structure and function of brain regions responsible for pain processing as well as brain regions that are commonly implicated in addiction. Several studies have shown "normalization" of structure and function in pain processing regions following discontinuation of the overused medication and resolution of MOH. However, some of the abnormalities in regions also implicated in addiction tend to persist following discontinuation of the overused medication, suggesting that they are a brain trait that predisposes certain individuals to medication overuse and MOH.
脑结构和功能的研究成像有助于阐明药物过量使用性头痛（MOH）的病理生理学。
这是一篇叙述性综述，回顾了研究MOH相关脑结构和功能改变的成像研究。本综述纳入的研究调查了MOH患者疼痛处理区域的异常结构和功能、可能使个体易患MOH的功能模式、MOH患者脑功能模式与成瘾者脑功能模式的相似性、可预测停用过量使用药物后头痛改善情况的脑结构，以及停用药物过量使用后脑结构和功能的变化。
MOH与负责疼痛处理的脑区以及通常与成瘾有关的脑区的非典型结构和功能有关。几项研究表明，停用过量使用的药物并解决MOH后，疼痛处理区域的结构和功能“正常化”。然而，一些也与成瘾有关的区域的异常在停用过量使用的药物后往往持续存在，这表明它们是一种脑特征，使某些个体易患药物过量使用和MOH。
