Triple network disruption in medication overuse headache: functional signatures and clinical impact
Abstract
BACKGROUND: Chronic migraine with medication overuse headache (CM-MOH) is a disabling neurological condition. CM-MOH is associated with functional impairment and high prevalence of psychiatric comorbidities. Neuroimaging research showed alterations in large-scale brain networks in chronic pain disorders. Among these, the so-called “triple network model” -Default Mode Network (DMN), Salience Network (SN), and Central Executive Network (CEN)- has garnered attention for its critical role in cognitive and emotional regulation. Dysregulation within and between these networks has been implicated in various chronic pain, substance abuse, and affective disorders. However, the role of triple network functional connectivity alterations in CM-MOH remains poorly understood. This study aims to investigate alterations in functional connectivity (FC) both within and between the triple networks and whole brain, and to explore how these neural changes relate to the clinical and psychiatric characteristics of CM-MOH. METHODS: This case-control study, 91 patients with CM-MOH and 35 healthy controls underwent clinical, neuropsychological, and resting-state fMRI assessments as part of the CM-MIND study. Patients were classified by type of medication overuse (triptans, NSAIDs, polyabusers). FC within and between the DMN, SN, and CEN, as well as whole-brain FC, was analyzed. Associations with clinical and psychiatric features (including allodynia, medication intake, anxiety, and depression) were…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 91 participants or records.
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