Cellular Adaptation in Migraineurs with Chronic Daily Headache

Hering, R.; Gardiner, Ion; Catarci, Teresa; Whitmarsh, Tom; Steiner, Timothy J.; Belleroche, Jacqueline de

doi:10.1046/j.1468-2982.1993.1304261.x

Cited by 25 publications

(17 citation statements)

References 15 publications

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“…the serotoninergic system is modulated by the intake of different classes of analgesics which will lead to alterations of the antinociceptive serotoninergic pathway and central sensitization [9-16]. Other mechanisms proposed involve the NMDA-receptor [17], the opioid- system [18], and alterations in membrane transduction [19]. …”

Section: Introductionmentioning

confidence: 99%

Prevalence of medication overuse headache in an interdisciplinary pain clinic

et al. 2013

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BackgroundMedication overuse headache (MOH) has been recognized as an important problem in headache patients although the pathophysiological mechanisms remain unclear. The diagnosis of MOH is based on clinical characteristics defined by the International Headache Society. The aim was the evaluation of the diagnostic criteria of MOH in a mixed population of chronic pain patients to gain information about the prevalence and possible associations with MOH.MethodsData of all patients referred to the interdisciplinary pain clinic at the University Hospital of Zurich between September 2005 and December 2007 were retrospectively analyzed. Demographic data (age, sex, history of migration), as well as data about duration of pain disease, category of pain disease (neurological, psychiatric, rheumatologic, other), use of medication, history of trauma, and comorbidity of depression and anxiety have been collected.ResultsTotally 178 of 187 consecutive chronic pain patients were included in the study. A total of 138 patients (78%) used analgesics on 15 or more days per month. Chronic headache was more prevalent among patients with analgesic overuse (39.8%) than without analgesic overuse (18%). The prevalence of MOH was 29%. The odds ratio (OR) for a patient with medication overuse to have chronic headache was 13.1 if he had a history of primary headache, compared to a patient without a primary headache syndrome. Furthermore, history of headache (OR 2.5, CI [1.13;5.44]), history of migration (OR 2.9, CI [1.31;6.32]) and comorbid depression (OR 3.5, CI [1.46;8.52]) were associated with overuse of acute medication, in general.ConclusionsPrimary headaches have a high risk for chronification in patients overusing analgesics for other pain disorders. Whereas history of headache, history of migration and comorbidity of depression are independentely associated with analgesic overuse in this group of patients.

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Section: Introductionmentioning

confidence: 99%

Prevalence of medication overuse headache in an interdisciplinary pain clinic

et al. 2013

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“…Srikiatkhachorn et al 23 suggested that the excessive use of SM could lead to an upregulation of central serotonergic receptors suppressing therefore the function of serotonergic pathways involved in central pain modulation. Hering et al 24 observed an increase in blood level of serotonin after withdrawal of overused SM in chronic daily headache patients. In addition, these authors analyzed the platelet membrane transduction of patients with daily headache suggesting that the overuse of SM would result in a modification of this process, possibly playing a role in such a headache pattern modification 25 .…”

Section: Methodsmentioning

confidence: 97%

Overuse of symptomatic medications among chronic (transformed) migraine patients: profile of drug consumption

Krymchantowski

2003

Arq. Neuro-Psiquiatr.

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-Chronic daily headache and chronic (transformed) migraine (TM) patients represent more than one third of the subjects seen in specialized headache centers. Most of these patients may overuse symptomatic medications (SM) taken on a daily basis to relieve headache and associated symptoms. The conversion to the daily or near-daily pattern of headache presentation is thought to be related to the medication overuse. The aim of this study was to evaluate the profile of SM consumption among transformed migraine patients attending a tertiary center. One hundred thirty three consecutive patients (22 men and 111 women, ages 17 to 80) with TM and overuse of SM according to the proposed criteria of Silberstein et al (1994Silberstein et al ( , 1996 were prospectively studied. None of the patients were under treatment for other conditions. Among them, 73 (54.9%) were using one category of SM, while 55 (41.3%) and 5 (3.8%) patients were taking simultaneously two and three categories of SM respectively. The categories of overused symptomatic medications varied from simple analgesics to narcotics, triptans and combinations of ergot derivatives and caffeine and of analgesics and caffeine. The average intake per patient per day was of 3 to 4 tablets and mostly of the patients overused simple analgesics (isolated or in combination with other substances) (75.2%), caffeine containing drugs (71.4%), drugs containing ergotamine derivatives (26.1%), triptans (alone or combined) (15.5%), drugs with narcotics or ansiolitics (13%) and antiinflammatory drugs (3.7%). The mechanisms by which the overuse of symptomatic medications may play a role in this transformation are uncertain but despite of the necessity of controlled trials to demonstrate the real role of such compounds in the development of transformed migraine, this study emphasizes the necessity for more rigorous prescribing guidelines for patients with frequent headaches.KEY WORDS: chronic (transformed) migraine, overuse, symptomatic medications, analgesic rebound headache.Uso excessivo de medicações sintomáticas em pacientes com migrânea crônica (transformada): perfil Uso excessivo de medicações sintomáticas em pacientes com migrânea crônica (transformada): perfil Uso excessivo de medicações sintomáticas em pacientes com migrânea crônica (transformada): perfil Uso excessivo de medicações sintomáticas em pacientes com migrânea crônica (transformada): perfil Uso excessivo de medicações sintomáticas em pacientes com migrânea crônica (transformada): perfil de consumo medicamentoso de consumo medicamentoso de consumo medicamentoso de consumo medicamentoso de consumo medicamentoso RESUMO -Os pacientes com cefaléia crônica diária e migrânea crônica (transformada) (MT) representam mais de um terço dos pacientes vistos em centros especializados. Muitos destes pacientes abusam de medicações sintomáticas (MS) tomadas em caráter diário para aliviar a cefaléia e/ou os sintomas associados. A conversão para o padrão de apresentação diário ou quase diário parece ser relacionada ao uso e...

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“…This finding is in accordance with the observation that chronic analgesic consumption has a significant effect on signal transduction mechanism. In 1993, Hering et al [36] found that analgesic withdrawal can induce a normalization of the abnormally upregulated thrombin-stimulated inositol phosphate production in platelet in a timedependent manner. They also found that this downregulation correlated with the improvement of headache.…”

Section: Dysfunction Of Central Serotonin System As a Mechanism Of Anmentioning

confidence: 99%

Pathophysiology of chronic daily headache

Srikiatkhachorn

2001

Current Science Inc

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Despite no clear explanation of the mechanism underlying chronic daily headache, sensitization of central nociceptive neurons is one possibility. Either prolonged activation of peripheral nociceptors or any factors that can alter the endogenous pain control system can trigger this process. A decrease in platelet serotonin has been observed in patients with chronic tension-type headache as well as migraine patients with medication-induced headache. It was also shown that chronic analgesic exposure led to changes in the serotonin content and the density of the 5-HT(2A) receptor in the cerebral cortex. The plasticity of the serotonin-dependent pain control system may facilitate the process of sensitization and results in the development of chronic daily headache.

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Cellular Adaptation in Migraineurs with Chronic Daily Headache

Cited by 25 publications

References 15 publications

Prevalence of medication overuse headache in an interdisciplinary pain clinic

Prevalence of medication overuse headache in an interdisciplinary pain clinic

Overuse of symptomatic medications among chronic (transformed) migraine patients: profile of drug consumption

Pathophysiology of chronic daily headache

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