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Neurotransmitter-related functional connectivity changes in serotonin and dopamine systems after mindfulness in medication overuse headache.

Davide Fedeli, Giuseppe Ciullo, Greta Demichelis, Jean Paul Medina Carrion, Maria Grazia Bruzzone, Emilio Ciusani, Alessandra Erbetta, Stefania Ferraro, Marina Grisoli, Erika Guastafierro, Danilo Antonio Montisano, Domenico D'Amico, Alberto Raggi, Anna Nigri, Licia Grazzi

Cephalalgia : an international journal of headache June 1, 2025 DOI: 10.1177/03331024251332561 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Longitudinal Peer reviewed
Sample size 34
Population Patients with chronic migraine and medication overuse headache
Intervention Mindfulness practice
Duration One year
Topics Meditation Neuroplasticity Serotonin
Keywords Medication overuse headache Resting State FMRI Awareness practice Contemplation Mindfulness practice Brain remodeling Neural changes Brain function Brain scans Neurobiology Brain imaging Brain chemistry Brain alterations Dopamine Chronic pain management Pain relief Pain therapy Pain treatment Pain management strategies Headache treatment Pain reduction Pain control
Citations 7
Key findings Adding mindfulness practice to standard treatment was associated with increased serotonin-enriched functional connectivity in the caudate and accumbens nuclei and increased dopamine-enriched functional connectivity in the right insular cortex after one year.

Abstract

Background/HypothesisMindfulness practice has gained attention in managing chronic migraine with medication overuse headache (CM-MOH), showing clinical improvements and functional connectivity reorganization. However, the relationship between these effects and the underlying neurotransmitter systems remains unexplored.MethodsThirty-four CM-MOH patients were divided into treatment as usual (TaU, N = 17) and mindfulness-added-to-TaU (TaU + MIND, N = 17) groups. Participants underwent resting-state fMRI scans before treatment and after one year. We adopted the neurotransmitter-related functional connectivity framework to investigate longitudinal functional changes associated with the distribution of serotonin, dopamine, and norepinephrine systems by comparing TaU + MIND with TaU groups.ResultsWhen compared with TaU, TaU + MIND patients longitudinally showed increased serotonin-enriched functional connectivity in the caudate and accumbens nuclei, and increased dopamine-enriched functional connectivity in the right insular cortex.Conclusion/InterpretationThese regions are involved in emotional, cognitive, and sensory modulation of pain and addiction. Our findings suggest the impact of mindfulness practice on serotonin and dopamine systems with potential beneficial effects in chronic pain management.

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