The role of the supratentorial neural network involved in addiction in patients with medication overuse headache in comparison to patients with chronic and episodic migraine.

• Applicant: Dr. Christoph Schankin
• Subject Area: Clinical Neurology; Neurosurgery and Neuroradiology
• Term: from 2010 to 2013
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 183448613

Medication overuse headache (MOH) and chronic migraine (CM) without medication overuse are chronic headache disorders based on episodic migraine (EM). They differ in the excessive use of analgesics in MOH. It is unclear why some patients develop medication overuse and others CM.MOH belongs to the spectrum of addictive behaviors, since it exhibits the characteristics of tolerance, dependence, and withdrawal. The neurobiological correlate of addiction (mesocorticolimbic dopamine system: nucleus accumbens (NAc), amygdala, prefrontal cortex (PFC), orbitofrontal cortex (OFC), anterior cingulate cortex (ACC)) overlaps with the ‘pain matrix’, which is involved in the mechanism of chronification in migraine. The hypotheses of the project applied for (to be executed at Prof. Goadsby’s group at the Headache Centery, UCSF, USA) are the following: 1) This overlapping neural system differs between patients with MOH overusing triptans and patients with CM without medication overuse or EM. This will be shown by voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). 2) The brain of patients with MOH overusing triptans differs from that of patients with CM or EM when examining the whole brain. 3) The degree of dependence-like behavior in MOH, measured on the severity of dependence scale (SDS), may correlate with the degree of such morphological differences.

• DFG Programme: Research Fellowships
• International Connection: USA
• Host: Professor Dr. Peter J. Goadsby