Abstract
Headaches are universal experiences and among the most common disorders. While headache may be physiological in the acute setting, it can become a pathological and persistent condition. The mechanisms underlying the transition from episodic to chronic pain have been the subject of intense study. Using physiological and imaging methods, researchers have identified a number of different forms of neural plasticity associated with migraine and other headaches, including peripheral and central sensitization, and alterations in the endogenous mechanisms of pain modulation. While these changes have been proposed to contribute to headache and pain chronification, some findings are likely the results of repetitive noxious stimulation, such as atrophy of brain areas involved in pain perception and modulation. In this review, we provide a narrative overview of recent advances on the neuroimaging, electrophysiological and genetic aspects of neural plasticity associated with the most common forms of chronic headaches, including migraine, cluster headache, tension-type headache, and medication overuse headache.
Highlights
In its 2010 Global Burden of Disease Survey, the World Health Organization reported tension-type headache (TTH) and migraine as the second (20.1%) and third (14.7%) most prevalent disorders in the world, exceeded only by dental caries [1]
While the definitions of chronic headaches will vary with their subtypes, as will their individual impacts, the great personal toll associated with chronic headache is well illustrated by chronic daily headache, whose sufferers experience headache for ≥15 days per month, for >3 months [5]
Researchers have examined whether the brain-derived neurotrophic factor (BDNF) Val66Met and wolframin His611Arg (WFSI) polymorphisms, both being linked to psychiatric illness and dependence behavior, might be related to MOH
Summary
In its 2010 Global Burden of Disease Survey, the World Health Organization reported tension-type headache (TTH) and migraine as the second (20.1%) and third (14.7%) most prevalent disorders in the world, exceeded only by dental caries [1]. An earlier meta-analysis of 107 studies reported the one-year prevalence of headaches among adults to be a staggering 46%, with TTH (42%), migraine (11%), and chronic daily headache (3%) standing out as the most common types [2]. With such statistics, headache has taken its place among the disorders plaguing the global population. The mechanisms responsible for the development of chronic headaches remain unknown Barring rare exceptions such as “new daily persistent headache,” most patients with chronic headaches initially experience only episodic attacks [6]. Emphasis will be laid on migraine as it is the most well studied type of these headaches
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