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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 1/2012

01-02-2012 | Chronic Daily Headache (SJ Wang, Section Editor)

Pathophysiology of Medication-overuse Headache: Implications from Animal Studies

Authors: Saknan Bongsebandhu-phubhakdi, Anan Srikiatkhachorn

Published in: Current Pain and Headache Reports | Issue 1/2012

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Abstract

Recent animal experiments have shown that chronic medication exposure profoundly affects the function of several areas in the nervous system related to headache pathogenesis. These changes include upregulation of calcitonin gene–related peptide, substance P, and nitric oxide synthase in trigeminal ganglia; expansion of receptive field and decreased nociceptive threshold of central trigeminal neurons; decrease in diffuse noxious inhibitory control; and increased susceptibility to develop cortical spreading depression (CSD). These changes indicate an increase in excitability of cortical and trigeminal neurons. The neuronal hyperexcitability may be the result of derangement of a central, possibly serotonin (5-HT)-dependent, modulating control system. Experiments with animals with low 5-HT showed that the processes of CSD and trigeminal nociception are enhanced in this condition. Derangement in the central 5-HT–dependent modulating system as a result of chronic medication use may underlie the chronification of headache as observed in patients with medication-overuse headache.
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Metadata
Title
Pathophysiology of Medication-overuse Headache: Implications from Animal Studies
Authors
Saknan Bongsebandhu-phubhakdi
Anan Srikiatkhachorn
Publication date
01-02-2012
Publisher
Current Science Inc.
Published in
Current Pain and Headache Reports / Issue 1/2012
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-011-0234-y

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