{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:28:00Z","timestamp":1783427280082,"version":"3.54.6"},"reference-count":26,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: MOH (medication overuse headache) is regarded as a complication of chronic migraines (CMs), with a general acknowledgment of reciprocal triggering between these two conditions. The present study aims to investigate the clinical parameters of relevance for the development of MOH among patients with CM, as well as for the subtype classification of MOHs. Method: We compared two groups of CM patients, with and without MOH, separated based on their demographic data and migraine characteristics. A subgroup of MOH accompanied by psychiatric co-morbidities (depression, anxiety, sleep disorder) was delineated, and the clinical features of relevance for the progression of MOH into the complicated state were evaluated. Results: The study revealed a higher prevalence of a family history of migraine in both the MOH and potentially complicated MOH subgroups (p &lt; 0.001, p = 0.036), along with a higher prevalence of bilateral pain localization (p = 0.033, 0.021). Symptoms commonly associated with migraines, such as nausea, vomiting, photophobia, phonophobia, and osmophobia, were more common in both the MOH and potentially complicated MOH subgroups (p &lt; 0.05). Furthermore, a positive correlation was found for the frequency (p &lt; 0.001) and severity (p = 0.010) of migraine attacks and the duration of headaches (p = 0.007), atopy (p = 0.017), sleep disturbances (p = 0.011), and emotional stress (p = 0.022) in the MOH group. Conclusion: We found a positive correlation between the prevalence of MOH among patients with CM and a family history of migraines, higher frequency and intensity of headaches, bilateral manifestation, sleep disturbances, and emotional stress. Moreover, symptoms accompanying migraines were found to be more prevalent in individuals with MOH and potentially complicated MOH.<\/jats:p>","DOI":"10.3390\/jcm13133696","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T12:46:56Z","timestamp":1719319616000},"page":"3696","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Complicated Form of Medication Overuse Headache Is Severe Version of Chronic Migraine"],"prefix":"10.3390","volume":"13","author":[{"given":"G\u00fclcan","family":"G\u00f6\u00e7mez Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Department of Neurology, Mersin City Training and Research Hospital, Mersin 33110, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3630-5674","authenticated-orcid":false,"given":"Reza","family":"Ghouri","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mersin University School of Medicine, Mersin 33110, Turkey"},{"name":"Neuroscience ad Neurotechnology Center of Excellence (N\u00d6ROM), Gazi University, Ankara 06570, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asena Ay\u00e7a","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Mersin University, Mersin 33343, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2797-2398","authenticated-orcid":false,"given":"Aynur","family":"\u00d6zge","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mersin University School of Medicine, Mersin 33110, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1111\/j.1468-2982.2009.01941.x","article-title":"Global prevalence of chronic migraine: A systematic review","volume":"30","author":"Natoli","year":"2009","journal-title":"Cephalalgia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1111\/j.1526-4610.2012.02223.x","article-title":"Chronic migraine prevalence, disability, and sociodemographic factors: Results from the American migraine prevalence and Prevention Study","volume":"52","author":"Buse","year":"2012","journal-title":"Headache"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 33, 629\u2013808.","DOI":"10.1177\/0333102413485658"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s10194-021-01224-8","article-title":"Medication overuse and drug addiction: A narrative review from addiction perspective","volume":"22","author":"Takahashi","year":"2021","journal-title":"J. Headache Pain"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.2147\/JPR.S46071","article-title":"Medication-overuse headache: A review","volume":"7","author":"Kristoffersen","year":"2014","journal-title":"J. Pain Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s10194-011-0388-3","article-title":"Chronic migraine plus medication overuse headache: Two entities or not?","volume":"12","author":"Negro","year":"2011","journal-title":"J. Headache Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s10194-011-0293-9","article-title":"Anxiety disorders in headache patients in a specialised clinic: Prevalence and symptoms in comparison to patients in a general neurological clinic","volume":"12","author":"Mehlsteibl","year":"2011","journal-title":"J. Headache Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/ane.13475","article-title":"Withdrawal failure in patients with chronic migraine and medication overuse headache","volume":"144","author":"Grazzi","year":"2021","journal-title":"Acta Neurol. Scand."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1177\/0333102420908579","article-title":"Brain metabolites in chronic migraine patients with medication overuse headache","volume":"40","author":"Niddam","year":"2020","journal-title":"Cephalalgia"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Giamberardino, M.A., and Martelletti, P. (2017). Comorbitidies in Headache Disorders, Springer International Publishing.","DOI":"10.1007\/978-3-319-41454-6"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/j.1468-2982.2004.00691.x","article-title":"Transformed migraine and medication overuse in a tertiary headache centre\u2014Clinical characteristics and treatment outcomes","volume":"24","author":"Bigal","year":"2004","journal-title":"Cephalalgia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/j.1526-4610.1982.hed2202066.x","article-title":"Transformation of migraine into daily headache: Analysis of factors","volume":"22","author":"Mathew","year":"1982","journal-title":"Headache"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1046\/j.1526-4610.2001.01088.x","article-title":"Medication induced (analgesic rebound) headache: Historical aspects and initial descriptions of the North American experience","volume":"41","author":"Capobianco","year":"2001","journal-title":"Headache"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s10194-020-1081-1","article-title":"The prevalence of primary headache disorders in Saudi Arabia: A cross-sectional population-based study","volume":"21","author":"Kojan","year":"2020","journal-title":"J. Headache Pain"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"03331024231157677","DOI":"10.1177\/03331024231157677","article-title":"Prevalence, natural history and dynamic nature of chronic headache and medication overuse headache in Italy: The SPARTACUS study","volume":"43","author":"Favoni","year":"2023","journal-title":"Cephalalgia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1177\/0333102418761047","article-title":"Factors associated to chronic migraine with medication overuse: A cross-sectional study","volume":"38","author":"Micele","year":"2018","journal-title":"Cephalalgia"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.nrl.2013.12.003","article-title":"Chronic migraine with and without medication overuse: Experience in a hospital series of 434 patients","volume":"30","author":"Rojo","year":"2015","journal-title":"Neurolog\u00eda"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1590\/S1679-45082012000300010","article-title":"Factors associated with acute medication overuse in chronic migraine patients","volume":"10","author":"Guendler","year":"2012","journal-title":"Einstein"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1111\/j.1468-2982.2006.01198.x","article-title":"Medication overuse headache: Type I and type II","volume":"26","author":"Saper","year":"2006","journal-title":"Cephalalgia"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S88","DOI":"10.1111\/j.1526-4610.2006.00560.x","article-title":"Medication overuse headache: Biobehavioral issues and solutions","volume":"46","author":"Lake","year":"2006","journal-title":"Headache"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/j.1468-2982.2005.00910.x","article-title":"Psychiatric comorbidity in the evolution from migraine to medication overuse headache","volume":"25","author":"Radat","year":"2005","journal-title":"Cephalalgia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3489","DOI":"10.1093\/brain\/awt251","article-title":"Cutaneous allodynia as a predictor of migraine chronification","volume":"136","author":"Louter","year":"2013","journal-title":"Brain"},{"key":"ref_23","unstructured":"Fischer, M.A., and Jan, A. (2023). Medication-Overuse Headache, StatPearls Publishing."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1177\/0333102411402367","article-title":"Pathophysiology of medication overuse headache: Insights and hypotheses from preclinical studies","volume":"31","author":"Meng","year":"2011","journal-title":"Cephalalgia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4069","DOI":"10.1016\/j.bjps.2022.08.036","article-title":"Morphologic vascular anomalies detected during migraine surgery","volume":"75","author":"Raposio","year":"2022","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1186\/s13063-022-06329-2","article-title":"Prevention of medication overuse and medication overuse headache in patients with migraine: A randomized, controlled, parallel, allocation-blinded, multicenter, prospective trial using a mobile software application","volume":"23","author":"Diener","year":"2022","journal-title":"Trials"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3696\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:04:08Z","timestamp":1760108648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3696"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,25]]},"references-count":26,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13133696"],"URL":"https:\/\/doi.org\/10.3390\/jcm13133696","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,25]]}}}