BACKGROUND Medication overuse headache may be associated with widespread alterations along the thalamocortical pathway, a pathway involved in pain perception and disease progression. This study addressed whether brain metabolites in key regions of the thalamocortical pathway differed between chronic migraine patients with medication overuse headache and without medication overuse headache. METHODS Magnetic resonance spectroscopic imaging was used to map metabolites in the bilateral anterior cingulate cortices, mid cingulate cortices, posterior cingulate cortices, and the thalami. Sixteen patients with medication overuse headache were compared with 16 matched patients without medication overuse headache and 16 matched healthy controls. RESULTS Glutamate and glutamine in the right mid cingulate cortex and myo-inositol in the left anterior cingulate cortex were significantly higher in patients with medication overuse headache than patients without medication overuse headache, but similar to healthy controls. Both patient groups exhibited reduced N-acetyl-aspartate and creatine in the thalamus, reduced myo-inositol in the right anterior cingulate cortex, and elevated choline in the right mid cingulate cortex. Finally, a negative association between myo-inositol laterality index in the anterior cingulate cortices and number of days per month with acute medication use was found across all patients. CONCLUSIONS Patients with medication overuse headache were characterized by a distinct concentration profile of myo-inositol, a glial marker, in the anterior cingulate cortices that may have arisen from medication overuse and could contribute to the development of medication overuse headache.

中文翻译：

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患有药物过度使用性头痛的慢性偏头痛患者的脑代谢物。

背景药物过度使用性头痛可能与丘脑皮质通路的广泛改变有关，该通路涉及疼痛感知和疾病进展。本研究探讨了丘脑皮层通路关键区域的脑代谢物在患有药物过度使用性头痛和没有药物过度使用性头痛的慢性偏头痛患者之间是否存在差异。方法 磁共振光谱成像用于绘制双侧前扣带回皮层、中扣带回皮层、后扣带回皮层和丘脑中的代谢物。16 名患有药物过度使用性头痛的患者与 16 名没有药物过度使用性头痛的匹配患者和 16 名匹配的健康对照者进行了比较。结果 药物过度使用性头痛患者右侧中扣带回皮质中的谷氨酸盐和谷氨酰胺以及左前扣带回皮质中的肌醇显着高于没有药物过度使用性头痛的患者，但与健康对照组相似。两组患者均表现出丘脑中 N-乙酰-天冬氨酸和肌酸减少，右侧前扣带回皮层中的肌醇减少，以及右侧中扣带回皮层中胆碱升高。最后，在所有患者中发现前扣带回皮质的肌醇侧向指数与每月急性药物使用天数之间存在负相关。结论 药物过度使用性头痛患者的特征在于肌醇的不同浓度特征，肌醇是一种神经胶质标志物，