{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:00:38Z","timestamp":1790395238475,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore whether patients with chronic migraine and medication overuse headache (CM\u2009+\u2009MOH) present with decision\u2010making deficit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Factors underlying MOH in patients with CM remain unclear. Whether the process of decision\u2010making plays a role in MOH is still controversial. Decision\u2010making varies in the degree of uncertainty: under ambiguity where the probability of outcome is unknown, and under risk where probabilities are known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Decisions under ambiguity and risk were assessed with the Iowa Gambling Task and the Cambridge Gambling Task, respectively, whereas executive function was assessed by the Wisconsin Card Sorting Test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 75 participants: 25 patients with CM\u2009+\u2009MOH, 25 with CM, and 25 age\u2010 and sex\u2010similar healthy controls (HCs), completed this cross\u2010sectional study. There was no significant difference in headache profiles except for more frequent analgesic use (mean\u2009\u00b1\u2009SD: 23.5\u2009\u00b1\u20097.6 vs. 6.8\u2009\u00b1\u20093.4\u2009days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and higher Severity of Dependence Scores (median [25th\u221275th percentile]: 8 [5\u201311] vs. 1 [0\u20134];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in patients with CM\u2009+\u2009MOH compared to CM. Total net score (mean\u2009\u00b1\u2009SD) on the Iowa Gambling Task in patients with CM\u2009+\u2009MOH, CM, and HCs were\u2009\u2212\u20098.1\u2009\u00b1\u200928.7, 10.9\u2009\u00b1\u200929.6, and 14.2\u2009\u00b1\u200928.8, respectively. There was a significant difference between the three groups (\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>(2, 72)<\/jats:sub>\n                      \u2009=\u20094.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017), with patients with CM\u2009+\u2009MOH making significantly more disadvantageous decisions than patients with CM (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024) and HCs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), while the CM and HC groups did not differ (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.690). By contrast, there was no significant difference between the groups in the Cambridge Gambling Task and the Wisconsin Card Sorting Test. Furthermore, performance on the Iowa Gambling Task was inversely correlated with analgesic consumption (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), suggesting that decision\u2010making under ambiguity may be related to MOH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data suggest that patients with CM\u2009+\u2009MOH had impaired decisions under ambiguous, but not risky situations. This dissociation indicates disrupted emotional feedback processing rather than executive dysfunction, which may underlie the pathogenesis of MOH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14513","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T06:13:28Z","timestamp":1685081608000},"page":"822-833","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Decision\u2010making impairment under ambiguity but not under risk may underlie medication overuse in patients with chronic migraine"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-2234","authenticated-orcid":false,"given":"Chi Ieong","family":"Lau","sequence":"first","affiliation":[{"name":"Dementia Center, Department of Neurology Shin Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"},{"name":"Applied Cognitive Neuroscience Group Institute of Cognitive Neuroscience, University College London  London UK"},{"name":"Institute of Biophotonics National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"College of Medicine Fu\u2010Jen Catholic University  New Taipei City Taiwan"},{"name":"Department of Medicine University Hospital  Taipa Macau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Hung","family":"Chen","sequence":"additional","affiliation":[{"name":"Dementia Center, Department of Neurology Shin Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"},{"name":"College of Medicine Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han\u2010Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Dementia Center, Department of Neurology Shin Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"},{"name":"College of Medicine National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Walsh","sequence":"additional","affiliation":[{"name":"Applied Cognitive Neuroscience Group Institute of Cognitive Neuroscience, University College London  London 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