Study Investigates Extent of Cognitive Impairment in Migraine

Those who suffer from migraine may also suffer from cognitive dysfunction. According to a recent study, migraine attacks are associated with poor cognitive performance compared with headache-free periods; however, additional research is needed to establish the effects of cognitive impairment in patients with migraine and other headache disorders.

The study, published by The Journal of Headache and Pain, involved a qualitative review of other studies that evaluated cognitive functions on migraine patients. The researchers collected the studies using PubMed and PsychInfo databases.

“Subjective cognitive decline is not uncommon in migraine patients. Although cognitive symptoms are not considered among the core symptomatology of migraine, many migraineurs often complain of intellectual impairment, particularly deficits in attention and memory,” the authors explained. “Cognitive symptoms are frequent in the premonitory phase and headache phase of a migraine attack and may also persist in the postdrome. Some migraineurs also complain of cognitive symptoms outside migraine attacks.”

The analysis revealed that individuals with migraine demonstrated impaired cognitive function interictally in most clinic-based studies, while population-based studies did not demonstrate a difference in cognitive function among those with migraine and controls. Also, neurophysiological, imaging, and pharmacological studies supported clinical symptoms of cognitive impairment in migraine while longitudinal studies did not suggest progressive cognitive decline over time, according to the results.

“Cognitive impairment in cross sectional, clinic-based studies showed that migraine affected certain cognitive domains in particular, such as processing speed, attention, memory, verbal skills and executive function (e.g. working memory, divided attention/inhibition, set-shifting, and planning),” the authors noted. “Migraine had a moderate to marked effect on processing speed and visuomotor scanning speed, whereas basic attention and delayed verbal memory were mildly affected, and more complex psychomotor processing speed tasks were not significantly affected.”

The researchers noted that preventive medications as well as comorbid disorders, such as depression and anxiety, can impact cognitive function. However, neither can completely explain the cognitive impairment in migraine. The study also found that tension type or cluster headaches are not associated with cognitive impairment during headache-free periods.

“There are limited number of studies about the cognitive performance in chronic migraine patients,” concluded the authors. “There are many unresolved questions and further studies are required in order to establish the extent of cognitive impairment in patients with migraine and other primary headache disorders and whether migraine prophylactic medications have an impact on reversal of cognitive dysfunction.”