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Background Medication-overuse headache (MOH) is a complication of migraine that causes significant burden and cost. Recent studies demonstrated metabolic and structural abnormalities in MOH 1,2, including a grey matter increase in the midbrain periaqueductal grey. We hypothesised that structural changes related to MOH should return to normal after medication withdrawal in patients with significant clinical improvement (responders). In contrast, no changes were expected in patients without improvement (nonresponders).

Grey matter changes in medication-overuse headache before and after medication withdrawal