Top

Published in:

01-05-2019 | Migraine | Original Article

Withdrawal from acute medication normalises short-term cortical synaptic potentiation in medication overuse headache

Authors: Francesca Cortese, Francesco Pierelli, Flavia Pauri, Cherubino Di Lorenzo, Chiara Lepre, Giulia Malavolta, Chiara Merluzzo, Vincenzo Parisi, Anna Ambrosini, Mariano Serrao, Gianluca Coppola

Published in: Neurological Sciences | Issue 5/2019

Abstract

Objectives

To study the effects of a standard acute medication withdrawal program on short-term cortical plasticity mechanisms in patients with medication overuse headache (MOH).

Methods

Thirteen patients with MOH and 16 healthy volunteers underwent repetitive transcranial magnetic stimulation (rTMS) over the left motor cortex; in patients with MOH, recordings were performed before and after a 3-week medication withdrawal program. Ten trains of 10 stimuli each (120% resting motor threshold) were delivered at 1 Hz or 5 Hz in two separate sessions in a randomised order. Motor evoked potential (MEP) amplitudes were measured from the right first dorsal interosseous muscle and the slope of the linear regression line from the first to the tenth stimuli was calculated for each participant.

Results

All subjects exhibited MEP amplitude inhibition in response to 1 Hz rTMS. Alternatively, the 5-Hz trains of rTMS inhibited rather than potentiated MEP amplitudes in patients with MOH. The physiological potentiating effect of 5 Hz rTMS on MEP amplitudes was restored after drug withdrawal and in proportion with the percentage reduction in monthly headache days in patients with MOH.

Conclusions

The results suggest that acute medication withdrawal normalises brain responses in patients with MOH. Clinical improvements after medication withdrawal may reflect the reversal of neurophysiological dysfunction. Accordingly, medication withdrawal should be offered to patients with MOH as early as possible in order to prevent the development of more pronounced alterations in brain plasticity.

No authors listed (2018) Headache Classification Committee of the International Headache Society (IHS) the international classification of headache disorders, 3rd edition. Cephalalgia 38:1–211. https://doi.org/10.1177/0333102417738202

Coppola G, Currà A, Di Lorenzo C et al (2010) Abnormal cortical responses to somatosensory stimulation in medication-overuse headache. BMC Neurol 10:126. https://doi.org/10.1186/1471-2377-10-126 CrossRefPubMedPubMedCentral

Siniatchkin M, Gerber WD, Kropp P, Vein A (1998) Contingent negative variation in patients with chronic daily headache. Cephalalgia 18:565–569 discussion 531CrossRefPubMed

Ferraro D, Vollono C, Miliucci R, Virdis D, de Armas L, Pazzaglia C, le Pera D, Tarantino S, Balestri M, di Trapani G, Valeriani M (2012) Habituation to pain in “medication overuse headache”: a CO2 laser-evoked potential study. Headache 52:792–807CrossRefPubMed

Rankin CH, Abrams T, Barry RJ, Bhatnagar S, Clayton DF, Colombo J, Coppola G, Geyer MA, Glanzman DL, Marsland S, McSweeney FK, Wilson DA, Wu CF, Thompson RF (2009) Habituation revisited: an updated and revised description of the behavioral characteristics of habituation. Neurobiol Learn Mem 92:135–138. https://doi.org/10.1016/j.nlm.2008.09.012 CrossRef

Cortese F, Pierelli F, Pauri F, di Lorenzo C, Lepre C, Malavolta G, Merluzzo C, Parisi V, Serrao M, Coppola G (2018) Short-term cortical synaptic depression/potentiation mechanisms in chronic migraine patients with or without medication overuse. Cephalalgia 033310241878474. https://doi.org/10.1177/0333102418784747

Currà A, Coppola G, Gorini M, Porretta E, Bracaglia M, di Lorenzo C, Schoenen J, Pierelli F (2011) Drug-induced changes in cortical inhibition in medication overuse headache. Cephalalgia 31:1282–1290. https://doi.org/10.1177/0333102411415877 CrossRefPubMed

Rossi P, Faroni JV, Tassorelli C, Nappi G (2013) Advice alone versus structured detoxification programmes for complicated medication overuse headache (MOH): a prospective, randomized, open-label trial. J Headache Pain 14:10. https://doi.org/10.1186/1129-2377-14-10 CrossRefPubMedPubMedCentral

Pascual-Leone A, Valls-Solé J, Wassermann EM, Hallett M (1994) Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex. Brain 117(Pt 4):847–858CrossRefPubMed

10.

Pascual-Leone A, Tormos JM, Keenan J, Tarazona F, Cañete C, Catalá MD (1998) Study and modulation of human cortical excitability with transcranial magnetic stimulation. J Clin Neurophysiol 15:333–343CrossRefPubMed

11.

Chen R, Classen J, Gerloff C, Celnik P, Wassermann EM, Hallett M, Cohen LG (1997) Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation. Neurology 48:1398–1403CrossRefPubMed

12.

García-Larrea L, Peyron R, Mertens P, Gregoire CM, Lavenne F, le Bars D, Convers P, Mauguière F, Sindou M, Laurent B (1999) Electrical stimulation of motor cortex for pain control: a combined PET-scan and electrophysiological study. Pain 83:259–273CrossRefPubMed

13.

Pagano RL, Fonoff ET, Dale CS, Ballester G, Teixeira MJ, Britto LRG (2012) Motor cortex stimulation inhibits thalamic sensory neurons and enhances activity of PAG neurons: possible pathways for antinociception. Pain 153:2359–2369. https://doi.org/10.1016/j.pain.2012.08.002 CrossRefPubMed

14.

Uddin LQ (2017) Anatomy of the salience network. In: Uddin LQ (ed) Salience Network of the Human Brain. Academic Press, Cambridge, pp 5–10

15.

Ayzenberg I, Obermann M, Nyhuis P, Gastpar M, Limmroth V, Diener HC, Kaube H, Katsarava Z (2006) Central sensitization of the trigeminal and somatic nociceptive systems in medication overuse headache mainly involves cerebral supraspinal structures. Cephalalgia 26:1106–1114. https://doi.org/10.1111/j.1468-2982.2006.01183.x CrossRefPubMed

16.

Perrotta A, Serrao M, Sandrini G, Burstein R, Sances G, Rossi P, Bartolo M, Pierelli F, Nappi G (2010) Sensitisation of spinal cord pain processing in medication overuse headache involves supraspinal pain control. Cephalalgia 30:272–284CrossRefPubMed

17.

Peyron R, García-Larrea L, Grégoire MC, Costes N, Convers P, Lavenne F, Mauguière F, Michel D, Laurent B (1999) Haemodynamic brain responses to acute pain in humans: sensory and attentional networks. Brain 122:1765–1780CrossRefPubMed

18.

Riederer F, Gantenbein AR, Marti M, Luechinger R, Kollias S, Sandor PS (2013) Decrease of gray matter volume in the midbrain is associated with treatment response in medication-overuse headache: possible influence of orbitofrontal cortex. J Neurosci 33:15343–15349CrossRefPubMedPubMedCentral

19.

Chen Z, Chen X, Liu M, Liu S, Ma L, Yu S (2017) Disrupted functional connectivity of periaqueductal gray subregions in episodic migraine. J Headache Pain 18:36. https://doi.org/10.1186/s10194-017-0747-9 CrossRefPubMedPubMedCentral

20.

Chen Z, Chen X, Liu M, Liu S, Ma L, Yu S (2017) Texture features of periaqueductal gray in the patients with medication-overuse headache. J Headache Pain 18:14. https://doi.org/10.1186/s10194-017-0727-0 CrossRefPubMedPubMedCentral

21.

Michels L, Christidi F, Steiger VR, Sándor PS, Gantenbein AR, Landmann G, Schreglmann SR, Kollias S, Riederer F (2017) Pain modulation is affected differently in medication-overuse headache and chronic myofascial pain – a multimodal MRI study. Cephalalgia 37:764–779. https://doi.org/10.1177/0333102416652625 CrossRefPubMed

22.

Chen Z, Jia Z, Chen X, Liu M, Liu S, Ma L, Yu S (2017) Volumetric abnormalities of thalamic subnuclei in medication-overuse headache. J Headache Pain 18:82. https://doi.org/10.1186/s10194-017-0791-5 CrossRefPubMedPubMedCentral

23.

Fumal A, Laureys S, Di Clemente L et al (2006) Orbitofrontal cortex involvement in chronic analgesic-overuse headache evolving from episodic migraine. Brain 129:543–550. https://doi.org/10.1093/brain/awh691 CrossRefPubMed

24.

Mehnert J, Hebestreit J, May A (2018) Cortical and subcortical alterations in medication overuse headache. Front Neurol 9:499. https://doi.org/10.3389/fneur.2018.00499 CrossRefPubMedPubMedCentral

Title: Withdrawal from acute medication normalises short-term cortical synaptic potentiation in medication overuse headache
Authors: Francesca Cortese
Francesco Pierelli
Flavia Pauri
Cherubino Di Lorenzo
Chiara Lepre
Giulia Malavolta
Chiara Merluzzo
Vincenzo Parisi
Anna Ambrosini
Mariano Serrao
Gianluca Coppola
Publication date: 01-05-2019
Publisher: Springer International Publishing
Keywords: Migraine
Motor Evoked Potential
Transcranial Magnetic Stimulation
Repetitive Transcranial Magnetic Stimulation
Motor Evoked Potential
Medication Overuse Headache
Headache
Transcranial Magnetic Stimulation
Published in: Neurological Sciences / Issue 5/2019
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-019-03735-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Withdrawal from acute medication normalises short-term cortical synaptic potentiation in medication overuse headache

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2019

L-type calcium channel blockers and a symptom complex mimicking de Melo-Souza’s syndrome

Association of uric acid with stenosis of intracranial and extracranial arteries in elderly patients with cerebral infarction

Recumbent stepping aerobic exercise in amyotrophic lateral sclerosis: a pilot study

A new neurobehavioral phenotype of familial Creutzfeldt–Jakob disease: impaired theory of mind

A case of functional dystonia: clinical cues to differentiate between organic and functional dystonia

Status and perspectives of acute stroke care in Europe