Li Chenhao, Dai Wei, Miao Shuai, Xie Wei, Yu Shengyuan
Department of Neurology, The First Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China.
Front Neurol. 2023 Mar 2;14:1118929. doi: 10.3389/fneur.2023.1118929. eCollection 2023.
It has yet to be determined whether medication overuse headache (MOH) is an independent disorder or a combination of primary headache and substance addiction. To further explore the causes of MOH, we compared MOH with substance use disorder (SUD) in terms of the brain regions involved to draw more targeted conclusions. In this review, we selected alcohol use disorder (AUD) as a representative SUD and compared MOH and AUD from two aspects of neuroimaging and basic research. We found that in neuroimaging studies, there were many overlaps between AUD and MOH in the reward circuit, but the extensive cerebral cortex damage in AUD was more serious than that in MOH. This difference was considered to reflect the sensitivity of the cortex structure to alcohol damage. In future research, we will focus on the central amygdala (CeA), prefrontal cortex (PFC), orbital-frontal cortex (OFC), hippocampus, and other brain regions for interventions, which may have unexpected benefits for addiction and headache symptoms in MOH patients.
药物过度使用性头痛（MOH）究竟是一种独立的疾病，还是原发性头痛与物质成瘾的组合，目前尚未确定。为了进一步探究MOH的病因，我们从涉及的脑区方面将MOH与物质使用障碍（SUD）进行比较，以得出更具针对性的结论。在本综述中，我们选择酒精使用障碍（AUD）作为SUD的代表，并从神经影像学和基础研究两个方面对MOH和AUD进行了比较。我们发现，在神经影像学研究中，AUD和MOH在奖赏回路方面存在许多重叠，但AUD中广泛的大脑皮层损伤比MOH中的更严重。这种差异被认为反映了皮层结构对酒精损伤的敏感性。在未来的研究中，我们将聚焦于中央杏仁核（CeA）、前额叶皮层（PFC）、眶额皮层（OFC）、海马体等脑区进行干预，这可能会给MOH患者的成瘾和头痛症状带来意想不到的益处。
