{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:12:54Z","timestamp":1791216774915,"version":"4.1.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Science and Technology Council, Taiwan","award":["107-2314-B-075-058-MY3 and 110-2314-B-075 -039 -MY"],"award-info":[{"award-number":["107-2314-B-075-058-MY3 and 110-2314-B-075 -039 -MY"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Chronic migraine with medication overuse (CMwMO) is a disabling phenotype of migraine with heterogenous responses to medication withdrawal and preventive treatments. We investigated whether baseline brain metabolic patterns reflect biological heterogeneity associated with 1-year clinical outcome in CMwMO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled patients with CMwMO and healthy controls and obtained baseline headache profiles, psychological and dependence-related assessment as well as FDG-PET\/MRI data. Patients received preventive treatments along with structured medication-withdrawal education. Poor outcome (n\u2009=\u200913) was defined as ongoing analgesic overuse together with &lt;50% reduction in monthly headache days compared with baseline at one year follow-up. All other patients (n\u2009=\u200914) were classified as having a good outcome. Whole-brain metabolic comparisons, seed-based metabolic covariance analyses, and correlations with clinical variables were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 27 patients with CMwMO, baseline headache frequency, disability, and medication use were similar between good and poor outcome groups, but the poor-outcome group was older, showed greater dependence severity, and had a longer duration of chronic headache. Compared with healthy controls (n\u2009=\u200917), only the poor-outcome group demonstrated hypermetabolism in the nucleus accumbens, thalamus, orbitofrontal cortex, and cerebellum. When compared to the good-outcome group, the poor-outcome group exhibited cerebellar hypermetabolism and stronger cerebellar metabolic covariance with the putamen and occipital cortex. Integrities of cerebellar-putamen metabolic coupling correlated with dependence severity, whereas cerebellar-occipital coupling correlated with duration of chronic headache and 1-year clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CMwMO appears to comprise biologically distinct subgroups with different baseline metabolic patterns. Treatment-refractory patients were characterized by metabolic alterations involving reinforcement and sensory prediction networks. Early identification of this subgroup may facilitate more individualized management targeting both headache burden and dependence-related behaviors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261476230","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T14:09:56Z","timestamp":1786457396000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Distinct brain metabolic patterns reflect biological heterogeneity and relate to clinical outcome in chronic migraine with medication overuse"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-9573","authenticated-orcid":false,"given":"Hung-Yu","family":"Liu","sequence":"first","affiliation":[{"name":"Taipei Veteran General Hospital"},{"name":"National Yang Ming Chiao Tung University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Hsien","family":"Yeh","sequence":"additional","affiliation":[{"name":"National Defense Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Lin","family":"Lee","sequence":"additional","affiliation":[{"name":"National Yang Ming Chiao Tung University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ing-Jou","family":"Chen","sequence":"additional","affiliation":[{"name":"Tri-Service General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0498-4695","authenticated-orcid":false,"given":"Yen-Hui","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Taipei Medical University Hospital, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Hsien","family":"Chou","sequence":"additional","affiliation":[{"name":"National Yang Ming Chiao Tung University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5179-5358","authenticated-orcid":false,"given":"Shuu-Jiun","family":"Wang","sequence":"additional","affiliation":[{"name":"Taipei Veteran General Hospital"},{"name":"National Yang Ming Chiao Tung University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00415-0"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-018-0875-x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21897"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2008.01257.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2010.01695.x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3804-12.2013"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2012.02276.x"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2016.05.007"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13030472"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1995.9056072.x"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1989.01810110054008"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.5.988"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.117229"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2009.01.045"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13229-015-0047-7"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_3_3_20_2","volume-title":"Statistical power analysis for the behavioral sciences. 2 ed","author":"Cohen J","year":"1988","unstructured":"Cohen J. 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