Withdrawal from acute medication normalises short-term cortical synaptic potentiation in medication overuse headache.


Journal

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175

Informations de publication

Date de publication:
May 2019
Historique:
received: 04 10 2018
accepted: 22 01 2019
pubmed: 3 2 2019
medline: 14 6 2019
entrez: 3 2 2019
Statut: ppublish

Résumé

To study the effects of a standard acute medication withdrawal program on short-term cortical plasticity mechanisms in patients with medication overuse headache (MOH). Thirteen patients with MOH and 16 healthy volunteers underwent repetitive transcranial magnetic stimulation (rTMS) over the left motor cortex; in patients with MOH, recordings were performed before and after a 3-week medication withdrawal program. Ten trains of 10 stimuli each (120% resting motor threshold) were delivered at 1 Hz or 5 Hz in two separate sessions in a randomised order. Motor evoked potential (MEP) amplitudes were measured from the right first dorsal interosseous muscle and the slope of the linear regression line from the first to the tenth stimuli was calculated for each participant. All subjects exhibited MEP amplitude inhibition in response to 1 Hz rTMS. Alternatively, the 5-Hz trains of rTMS inhibited rather than potentiated MEP amplitudes in patients with MOH. The physiological potentiating effect of 5 Hz rTMS on MEP amplitudes was restored after drug withdrawal and in proportion with the percentage reduction in monthly headache days in patients with MOH. The results suggest that acute medication withdrawal normalises brain responses in patients with MOH. Clinical improvements after medication withdrawal may reflect the reversal of neurophysiological dysfunction. Accordingly, medication withdrawal should be offered to patients with MOH as early as possible in order to prevent the development of more pronounced alterations in brain plasticity.

Identifiants

pubmed: 30710190
doi: 10.1007/s10072-019-03735-4
pii: 10.1007/s10072-019-03735-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

963-969

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Auteurs

Francesca Cortese (F)

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy. francesca.cortese05@libero.it.

Francesco Pierelli (F)

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
IRCCS Neuromed, Pozzilli, IS, Italy.

Flavia Pauri (F)

Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, "Sapienza" University of Rome, Rome, Italy.

Cherubino Di Lorenzo (C)

IRCCS - Fondazione Don Carlo Gnocchi, Milan, Italy.

Chiara Lepre (C)

Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, "Sapienza" University of Rome, Rome, Italy.

Giulia Malavolta (G)

Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, "Sapienza" University of Rome, Rome, Italy.

Chiara Merluzzo (C)

Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, "Sapienza" University of Rome, Rome, Italy.

Vincenzo Parisi (V)

Research Unit of Neurophysiology of Vision and Neurophthalmology, IRCCS - Fondazione Bietti, Rome, Italy.

Anna Ambrosini (A)

IRCCS Neuromed, Pozzilli, IS, Italy.

Mariano Serrao (M)

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.

Gianluca Coppola (G)

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.

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