Altered expressions of CGRP, SULT1A1, HMGB1, and HIF-1α in the trigeminal ganglion in medication overuse headache in female rats

Our study showed for the first time that NSAID overuse headache is associated with a robust increase in CGRP, HMGB1, and HIF-1α and reduced SULT1A1 expression in the trigeminal ganglion. Increased nociceptive, inflammatory, and mitochondrial stress signaling in the trigeminal ganglion cells may drive sustained trigeminal nociceptive activity in MOH. Besides, reduced SULT1A1 expression in the trigeminal ganglion suggests reduced capacity of detoxification and catecholamine metabolism in MOH. The role of lipopolysaccharide leakage and systemic nociceptive drive on trigeminal neurons remains to be clarified.