title: Overuse of paracetamol caffeine aspirin powders affects cerebral glucose metabolism in chronic migraine patients.
abstract: OBJECTIVE
  Overuse of analgesic plays a prominent role in migraine chronification. Paracetamol caffeine aspirin (PCA) powders are commonly used in Chinese migraineurs. This study investigated the effects of the specific combination analgesic on cerebral glucose metabolism in chronic migraine (CM).
  
  
  METHODS
  18F-FDG-PET was used to measure regional metabolism in all subjects. Brain metabolisms of CM patients with analgesic overuse (AO-CM; n=10), no analgesic overuse (NAO-CM; n=10), and no regimen (NR-CM; n=10) and 17 age- and gender-matched normal controls (NC) were compared using statistical parametric mapping. Then, all patients underwent brain MRI analysis within 7 days after PET scans, as well as MMSE and MoCA scale for cognitive function tests.
  
  
  RESULTS
  Glucose metabolic changes in CM patients taking different dosage of analgesic during headache-free periods and clear distinctions in several brain regions were observed. Patients with AO-CM exhibited significant metabolic reductions in thalamus, as well as increased metabolism in middle temporal gyrus and insula relative to NR-CM and NAO-CM. However, in these regions, no difference was observed in AO-CM except for increased metabolism in the right insula relative to NC group.
  
  
  CONCLUSIONS
  Overusing PCA powders affects regional brain glucose metabolism in CM. Increased metabolism in the right insula may be associated with recurrently overusing of PCA powders.
authors.affiliation: Department of Neurology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: W
authors.initials: W
authors.lastname: Di
authors.forename: X
authors.initials: X
authors.lastname: Shi
authors.forename: Y
authors.initials: Y
authors.lastname: Zhu
authors.forename: Y
authors.initials: Y
authors.lastname: Tao
authors.forename: W
authors.initials: W
authors.lastname: Qi
authors.forename: N
authors.initials: N
authors.lastname: Luo
authors.forename: Z
authors.initials: Z
authors.lastname: Xiao
authors.forename: C
authors.initials: C
authors.lastname: Yi
authors.forename: J
authors.initials: J
authors.lastname: Miao
authors.forename: A
authors.initials: A
authors.lastname: Zhang
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Fang
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001921:Brain / Q000000981:diagnostic imaging; D001923:Brain Chemistry / Q000187:drug effects; D002110:Caffeine / Q000009:adverse effects*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002908:Chronic Disease; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D051271:Headache Disorders, Secondary / Q000378:metabolism*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism*; D009483:Neuropsychological Tests; D010147:Pain Measurement; D049268:Positron-Emission Tomography; D011208:Powders; D019275:Radiopharmaceuticals
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000697:Central Nervous System Stimulants; D011208:Powders; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000082:Acetaminophen; D002110:Caffeine; D005947:Glucose; D001241:Aspirin