1 Department of Pharmaceutical Sciences and Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale "A. Avogadro", Novara, Italy.
2 Headache Science Center, C. Mondino National Neurological Institute, Pavia, Italy.
Cephalalgia. 2018 Jun;38(7):1361-1373. doi: 10.1177/0333102417728244. Epub 2017 Sep 4.
Purpose of review Medication-overuse headache is a secondary chronic headache disorder, evolving from an episodic primary headache type, caused by the frequent and excessive use of headache symptomatic drugs. While gene polymorphisms have been deeply investigated as susceptibility factors for migraine, little attention has been paid to medication-overuse headache genetics. In the present study we conducted a systematic review to identify, appraise and summarize the current findings of gene polymorphism association studies in medication-overuse headache. Methods A comprehensive literature search was conducted on PubMed and Web of Knowledge databases of primary studies that met the diagnostic criteria for medication-overuse headache according to the temporally-relevant Classification of Headache Disorder of the International Headache Society. Results A total of 17 candidate gene association studies focusing on medication-overuse headache were finally included in the qualitative review. Among these, 12 studies investigated the role of common gene polymorphisms as risk factors for medication-overuse headache susceptibility, six studies focused on the relationship with clinical features of medication-overuse headache patients, and four studies evaluated their role as determinants of clinical outcomes in medication-overuse headache patients. Conclusion Results of single studies show a potential role of polymorphic variants of the dopaminergic gene system or of other genes related to drug-dependence pathways as susceptibility factors for disease or as determinants of monthly drug consumption, respectively. In this systematic review, we summarize the findings of gene polymorphism association studies in medication-overuse headache and discuss the methodological issues that need to be addressed in the design of future studies.
药物过度使用性头痛是一种继发性慢性头痛疾病，由发作性原发性头痛类型演变而来，由频繁和过度使用头痛对症药物引起。虽然基因多态性已被深入研究为偏头痛的易感性因素，但对药物过度使用性头痛的遗传学关注甚少。在本研究中，我们进行了一项系统评价，以确定、评估和总结药物过度使用性头痛基因多态性关联研究的现有发现。
根据国际头痛协会的时间相关头痛障碍分类标准，对符合药物过度使用性头痛诊断标准的原发性研究的 PubMed 和 Web of Knowledge 数据库进行了全面的文献检索。
最终纳入了 17 项针对药物过度使用性头痛的候选基因关联研究进行定性综述。其中，12 项研究探讨了常见基因多态性作为药物过度使用性头痛易感性的风险因素的作用，6 项研究集中于药物过度使用性头痛患者的临床特征的关系，4 项研究评估了它们在药物过度使用性头痛患者的临床结局中的决定作用。
单项研究的结果表明，多巴胺能基因系统的多态性变异或与药物依赖途径相关的其他基因的多态性变异分别作为疾病的易感性因素或作为每月药物消耗的决定因素具有潜在作用。在本系统评价中，我们总结了药物过度使用性头痛基因多态性关联研究的结果，并讨论了未来研究设计中需要解决的方法学问题。
