Clinical and biobehavioral perspectives: Is medication overuse headache a behavior of dependence?

Lau, Chi Ieong; Liu, Mu-N; Chen, Wei Hung; Walsh, Vincent; Wang, Shuu Jiun

doi:10.1016/bs.pbr.2020.05.019

Cited by 5 publications

(11 citation statements)

References 142 publications

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“…Furthermore, a derangement of the mesolimbic reward system, in particular the mesocorticolimbic dopaminergic circuit, has been described in OCD patients. This is similar to that which has been documented in addicted individuals [ 26 ]. These data have also been confirmed by functional MRI connectivity studies [ 31 ].…”

Section: Discussionsupporting

confidence: 91%

“…MOH and OCD seem to share a common pathophysiological substrate because both appear to present alterations in the striatal—thalamic—orbitofrontal circuit [ 8 , 24 , 25 ]. Recent studies have shown that compulsive drug addiction behaviours and MOH share similar cognitive problems, including the impairment of decision-making mechanisms and an imbalance of the adaptive reward systems [ 26 ]. Functional imaging studies have shown alterations in the mesocorticolimbic reward circuitry in both conditions [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown that compulsive drug addiction behaviours and MOH share similar cognitive problems, including the impairment of decision-making mechanisms and an imbalance of the adaptive reward systems [ 26 ]. Functional imaging studies have shown alterations in the mesocorticolimbic reward circuitry in both conditions [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Onabotulinum Toxin A on Obsessive–Compulsive Traits in a Population of Chronic Migraine Patients

Viticchi

Falsetti²,

Salvemini³

et al. 2022

Brain Sciences

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Background: Drug addiction may play an important role in chronic migraine (CM) with medication-overuse headache (MOH). Psychiatric diseases are associated with CM, but data regarding obsessive–compulsive disorder (OCD) are lacking. We aimed to establish the prevalence of OCD traits in CM patients with MOH and the impact on onabotulinum toxin A (OBT-A) treatment. Methods: A total of 75 patients with CM and MOH undergoing treatment with OBT-A in our Headache Centre were evaluated. At baseline and after four injection sessions, we assessed the migraine burden and the presence of OCD traits with the Obsessive–Compulsive Inventory—Revised (OCI-R) test. Results: At baseline, 28% of patients had OCI-R scores compatible with borderline OCD aspects, while 22.7% were pathological. An improvement in headache was significantly associated with an increase in the number of subjects with a normal OCI-R score at T0 and T1, whereas patients with a pathological OCI-R score at T0 showed a significantly higher prevalence of CM at T1. Conclusions: Our data showed a significant rate of OCD traits at baseline, which could strengthen the hypothesis of an addictive disorder underlying CM with MOH. OCD traits seem to influence the OBT-A response. An OCD assessment could be useful in improving patients’ selections before starting treatments.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy of Onabotulinum Toxin A on Obsessive–Compulsive Traits in a Population of Chronic Migraine Patients

Viticchi

Falsetti²,

Salvemini³

et al. 2022

Brain Sciences

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“…It is still unclear why a certain portion of patients with chronic migraine (CM) are more vulnerable to developing MOH. Considering the high relapse rate of MOH, there has been debate on whether MOH can be seen as a dependence‐like behavior 2 . For instance, nearly half to two‐thirds of patients with MOH fulfilled the Diagnostic and Statistical Manual of Mental Disorders, version IV (DSM‐IV) criteria for substance dependence 3–5 .…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, there are increased psychiatric comorbidities such as obsessive–compulsive disorder (OCD), anxiety, and depression in those with MOH compared to controls 7 . Thus, other than pain alone, there might be other unknown factors that are driving the development of MOH 2 …”

Section: Introductionmentioning

confidence: 99%

Decision‐making impairment under ambiguity but not under risk may underlie medication overuse in patients with chronic migraine

et al. 2023

Self Cite

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Objective To explore whether patients with chronic migraine and medication overuse headache (CM + MOH) present with decision‐making deficit. Background Factors underlying MOH in patients with CM remain unclear. Whether the process of decision‐making plays a role in MOH is still controversial. Decision‐making varies in the degree of uncertainty: under ambiguity where the probability of outcome is unknown, and under risk where probabilities are known. Methods Decisions under ambiguity and risk were assessed with the Iowa Gambling Task and the Cambridge Gambling Task, respectively, whereas executive function was assessed by the Wisconsin Card Sorting Test. Results A total of 75 participants: 25 patients with CM + MOH, 25 with CM, and 25 age‐ and sex‐similar healthy controls (HCs), completed this cross‐sectional study. There was no significant difference in headache profiles except for more frequent analgesic use (mean ± SD: 23.5 ± 7.6 vs. 6.8 ± 3.4 days; p < 0.001) and higher Severity of Dependence Scores (median [25th−75th percentile]: 8 [5–11] vs. 1 [0–4]; p < 0.001) in patients with CM + MOH compared to CM. Total net score (mean ± SD) on the Iowa Gambling Task in patients with CM + MOH, CM, and HCs were − 8.1 ± 28.7, 10.9 ± 29.6, and 14.2 ± 28.8, respectively. There was a significant difference between the three groups (F(2, 72) = 4.28, p = 0.017), with patients with CM + MOH making significantly more disadvantageous decisions than patients with CM (p = 0.024) and HCs (p = 0.008), while the CM and HC groups did not differ (p = 0.690). By contrast, there was no significant difference between the groups in the Cambridge Gambling Task and the Wisconsin Card Sorting Test. Furthermore, performance on the Iowa Gambling Task was inversely correlated with analgesic consumption (r = −0.41, p = 0.003), suggesting that decision‐making under ambiguity may be related to MOH. Conclusions Our data suggest that patients with CM + MOH had impaired decisions under ambiguous, but not risky situations. This dissociation indicates disrupted emotional feedback processing rather than executive dysfunction, which may underlie the pathogenesis of MOH.

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Innovative Vinci Power Nap® Neurotechnology System—To Reset and Reconnect the Senses, Body and Mind; Reducing Stress, Improving Performance, Sleep, Health and Quality of Life

Filcek¹

2022

Resilient and Responsible Smart Cities

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Clinical and biobehavioral perspectives: Is medication overuse headache a behavior of dependence?

Cited by 5 publications

References 142 publications

Efficacy of Onabotulinum Toxin A on Obsessive–Compulsive Traits in a Population of Chronic Migraine Patients

Efficacy of Onabotulinum Toxin A on Obsessive–Compulsive Traits in a Population of Chronic Migraine Patients

Decision‐making impairment under ambiguity but not under risk may underlie medication overuse in patients with chronic migraine

Innovative Vinci Power Nap® Neurotechnology System—To Reset and Reconnect the Senses, Body and Mind; Reducing Stress, Improving Performance, Sleep, Health and Quality of Life

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