It has been estimated that half of the patients with chronic headache types have medication-overuse headache. If you’re taking abortive medication for more than 10 days each month, you may have medication-overuse headache (commonly called rebound headache).
MOH could be a result of abortive medications such as triptans, paracetamol / acetaminophen, ibuprofen, and many others. The good news is that most patients seem to improve once they stop taking the medication. They also tend to respond better to preventative medications.
The bad news is that some patients do not improve – a significant number. Has the medication overuse done permanent damage to the brain?
A study in Switzerland, published last month, investigated grey matter changes in the brain to see if there was a difference among patients who did improve and who didn’t.
Changes in grey matter related to chronic pain are well known. But could these changes predict how well a patient will respond to treatment?
These researchers believe so. The evidence demonstrated that there were indeed differences between patients who improved and patients who did not. A lot of the difference could be seen in the orbitofrontal cortex area of the brain.
The orbitofrontal cortex is one of the least-understood areas of the brain, but it does seem to relate to decision-making, mood, and social interactions.
This study is another reminder of how important it is to get proper ongoing treatment. It also shows again that every patient is different. It may give us clues about how well certain patients will respond to certain treatments, and how headache conditions and other chronic pain conditions impact the brain physically.
- The study: Decrease of Gray Matter Volume in the Midbrain is Associated with Treatment Response in Medication-Overuse Headache: Possible Influence of Orbitofrontal Cortex.
- The International Classification of Headache Disorders, 3rd edition (beta version)
- The Mysterious Orbitofrontal Cortex.
- Neuroscientific Foundations of Anesthesiology