Decreased iron deposition in ventral pallidum associated with analgesic dependence and relapse in medication-overuse headache

Motivation: Studies suggest that repeated migraine attacks may impair iron homeostasis in migraineurs, potentially harming nervous function. Goal(s): To explore how medication overuse headache (MOH) affects iron accumulation in chronic migraine (CM) patients. Approach: we utilized quantitative susceptibility mapping (QSM) to assess and compare iron content in the subcortical regions of CM patients with and without MOH, while the relationships between iron deposition, disease course, functional disabilities and relapse in MOH were also investigated. Results: We demonstrated significantly lower QSM values in the ventral pallidum and putamen. Notably, iron deposition in the VeP was negatively correlated with relapse rates and severity of analgesic dependence. Impact: Our findings show excessive iron accumulation in subcortical areas correlates with increased migraine burden. VeP iron levels are linked to analgesic dependence and MOH relapse, emphasizing disrupted iron homeostasis in migraine pathology and its implications for treatment strategies.