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Yeral C, Yaman H, Gündoğdu O, Mutlu BÖ, Polat B, Yılmaz O. Does migraine affect central auditory processing abilities? Clin Neurol Neurosurg 2024; 243:108364. [PMID: 38838420 DOI: 10.1016/j.clineuro.2024.108364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE Migraine is a neurological disease associated with an altered cortical excitability level. Several studies have investigated the relationship between migraine and central auditory processing (CAP), with deficits in CAP being common among migraine patients. However, studies on the factors affecting these CAP changes observed in migraine patients are still few and controversial. This study aims to investigate CAP changes in migraine patients with Duration Pattern Test (DPT) and Frequency Pattern Test (FPT), which have not been used in previous studies. METHODS Sixty subjects were divided into two groups and one migraine subgroup: control group, twenty normal healthy subjects, fourty subjects diagnosed with migraine. They were evaluated using the CAP test including DPT and FPT. To identify the variables and possible effects of the variables, a questionnaire describing the characteristics of migraine features was administered to participants with migraine. RESULTS No significant difference was found the between the control and study group in CAP tests scores. No significant correlation was found between migraine characteristics and CAP tests scores. Males had significantly higher FPT scores in both ears than females (p<0.05). Significant statistical negative correlation was found between age and FPT scores for both ears and left DPT scores (p<0.05). CONCLUSION Although migraine patients generally showed lower CAP ability than the control group, no significant difference was observed between them. This was also valid for subgroups of migraine. However, as age increased in the migraine group, a significant decrease in CAP performance was observed. It was observed that male migraine patients had better CAP ability, especially FPT scores. Migraine may affect performance in CAP depending on gender and age factors.
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Affiliation(s)
- Cem Yeral
- Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
| | - Handan Yaman
- Department of Audiology, Istanbul Medipol University Mega Hospital, Istanbul, Türkiye; Functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Türkiye.
| | - Oğulcan Gündoğdu
- Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
| | - Berna Özge Mutlu
- Department of Audiology, Istanbul Medipol University Mega Hospital, Istanbul, Türkiye.
| | - Burcu Polat
- Department of Neurology, School of Medicine, Duzce University, Duzce, Türkiye.
| | - Oğuz Yılmaz
- Department of Audiology, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Türkiye.
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2
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Chowdhury D, Datta D, Mundra A, Duggal A, Krishnan A. Interictal Dysfunctions of Attention, Vigilance, and Executive Functions in Migraine and Their Reversal by Preventive Treatment: A longitudinal Controlled Study. Ann Indian Acad Neurol 2024; 27:254-263. [PMID: 38819434 DOI: 10.4103/aian.aian_40_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/11/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVE To assess attention, vigilance, and executive functions in migraine patients during headache-free (interictal) periods and in healthy controls without migraine and to study the impact of migraine preventive treatment on these cognitive functions. METHODS Preventive drug-naive migraine patients, aged ≥18 years, without a history of medication overuse were studied and compared to non-migraine controls. Psychiatric comorbidity was screened by Patient Health Questionnaire-9, and those who screened positive were evaluated further by specific scales. The Epworth Sleepiness Scale assessed subjective complaints of sleep quality. Cognitive functions were assessed by Mini-Mental State Examination (MMSE), digit span forward and backward (DS-F, DS-B), trail-making tests (TMT-A and B) and Stroop word (SW), Stroop color (SC), and Stroop interference (SI) tests. Cognitive test scores at the end of 6 months following treatment were compared to baseline scores. RESULTS One hundred and fifty migraine patients and controls each were studied. Compared to controls, migraine patients performed significantly worse in DS-B ( P < 0.0001), TMT-A ( P = 0.00004), TMT-B ( P < 0.0001), SW ( P < 0.0001), SC ( P < 0.0001), and SI ( P = 0.0221). MMSE scores did not differ between patients and the controls ( P = 0.3224). Compared to the patients without psychiatric comorbidity, migraine patients with psychiatric comorbidity showed no significant differences in the cognitive test scores. Significant improvement in all cognitive test scores ( P < 0.001) was observed after 6 months of treatment. CONCLUSION Migraine patients, compared to non-migraine controls, showed deficits in attention, vigilance, and executive functions during the interictal period, which improved with successful preventive treatment. Psychiatric comorbidities did not have a significant impact on cognitive dysfunctions.
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Affiliation(s)
- Debashish Chowdhury
- Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi
| | - Debabrata Datta
- Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi
| | - Ankit Mundra
- Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi
| | - Ashish Duggal
- Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi
| | - Anand Krishnan
- Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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3
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Paungarttner J, Quartana M, Patti L, Sklenárová B, Farham F, Jiménez IH, Soylu MG, Vlad IM, Tasdelen S, Mateu T, Marsico O, Reina F, Tischler V, Lampl C. Migraine - a borderland disease to epilepsy: near it but not of it. J Headache Pain 2024; 25:11. [PMID: 38273253 PMCID: PMC10811828 DOI: 10.1186/s10194-024-01719-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Migraine and epilepsy are two paroxysmal chronic neurological disorders affecting a high number of individuals and being responsible for a high individual and socioeconomic burden. The link between these disorders has been of interest for decades and innovations concerning diagnosing and treatment enable new insights into their relationship. FINDINGS Although appearing to be distinct at first glance, both diseases exhibit a noteworthy comorbidity, shared pathophysiological pathways, and significant overlaps in characteristics like clinical manifestation or prophylactic treatment. This review aims to explore the intricate relationship between these two conditions, shedding light on shared pathophysiological foundations, genetic interdependencies, common and distinct clinical features, clinically overlapping syndromes, and therapeutic similarities. There are several shared pathophysiological mechanisms, like CSD, the likely underlying cause of migraine aura, or neurotransmitters, mainly Glutamate and GABA, which represent important roles in triggering migraine attacks and seizures. The genetic interrelations between the two disorders can be observed by taking a closer look at the group of familial hemiplegic migraines, which are caused by mutations in genes like CACNA1A, ATP1A2, or SCN1A. The intricate relationship is further underlined by the high number of shared clinical features, which can be observed over the entire course of migraine attacks and epileptic seizures. While the variety of the clinical manifestation of an epileptic seizure is naturally higher than that of a migraine attack, a distinction can indeed be difficult in some cases, e.g. in occipital lobe epilepsy. Moreover, triggering factors like sleep deprivation or alcohol consumption play an important role in both diseases. In the period after the seizure or migraine attack, symptoms like speech difficulties, tiredness, and yawning occur. While the actual attack of the disease usually lasts for a limited time, research indicates that individuals suffering from migraine and/or epilepsy are highly affected in their daily life, especially regarding cognitive and social aspects, a burden that is even worsened using antiseizure medication. This medication allows us to reveal further connections, as certain antiepileptics are proven to have beneficial effects on the frequency and severity of migraine and have been used as a preventive drug for both diseases over many years. CONCLUSION Migraine and epilepsy show a high number of similarities in their mechanisms and clinical presentation. A deeper understanding of the intricate relationship will positively advance patient-oriented research and clinical work.
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Affiliation(s)
| | - Martina Quartana
- Department of Sciences for Health Promotion and Mother-and Childcare "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Lucrezia Patti
- Department of Sciences for Health Promotion and Mother-and Childcare "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Barbora Sklenárová
- St. Anne's University Hospital and Masaryk University, Brno, Czech Republic
| | - Fatemeh Farham
- Headache Department, Iranian Center of Neurological Researchers, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - M Gokcen Soylu
- Department of Neurology, Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey
| | - Irina Maria Vlad
- Department of Neurosciences, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Semih Tasdelen
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Teresa Mateu
- Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Neurology, Fundació Sanitària Mollet, Mollet del Vallès, Barcelona, Spain
| | - Oreste Marsico
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
- Regional Epilepsy Centre, Great Metropolitan "Bianchi-Melacrino-Morelli Hospitall", Reggio Calabria, Italy
| | - Federica Reina
- NeuroTeam Life&Science, Spin-off University of Palermo, Palermo, Italy
| | - Viktoria Tischler
- Headache Medical Center Linz, Linz, Austria
- Department of Neurology and Stroke Unit, Konventhospital Barmherzige Brüder Linz, Linz, Austria
| | - Christian Lampl
- Headache Medical Center Linz, Linz, Austria.
- Department of Neurology and Stroke Unit, Konventhospital Barmherzige Brüder Linz, Linz, Austria.
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Fila M, Pawlowska E, Szczepanska J, Blasiak J. Different Aspects of Aging in Migraine. Aging Dis 2023; 14:2028-2050. [PMID: 37199585 PMCID: PMC10676778 DOI: 10.14336/ad.2023.0313] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/13/2023] [Indexed: 05/19/2023] Open
Abstract
Migraine is a common neurological disease displaying an unusual dependence on age. For most patients, the peak intensity of migraine headaches occurs in 20s and lasts until 40s, but then headache attacks become less intense, occur less frequently and the disease is more responsive to therapy. This relationship is valid in both females and males, although the prevalence of migraine in the former is 2-4 times greater than the latter. Recent concepts present migraine not only as a pathological event, but rather as a part of evolutionary adaptive response to protect organism against consequences of stress-induced brain energy deficit. However, these concepts do not fully explain that unusual dependence of migraine prevalence on age. Many aspects of aging, both molecular/cellular and social/cognitive, are interwound in migraine pathogenesis, but they neither explain why only some persons are affected by migraine, nor suggest any causal relationship. In this narrative/hypothesis review we present information on associations of migraine with chronological aging, brain aging, cellular senescence, stem cell exhaustion as well as social, cognitive, epigenetic, and metabolic aging. We also underline the role of oxidative stress in these associations. We hypothesize that migraine affects only individuals who have inborn, genetic/epigenetic, or acquired (traumas, shocks or complexes) migraine predispositions. These predispositions weakly depend on age and affected individuals are more prone to migraine triggers than others. Although the triggers can be related to many aspects of aging, social aging may play a particularly important role as the prevalence of its associated stress has a similar age-dependence as the prevalence of migraine. Moreover, social aging was shown to be associated with oxidative stress, important in many aspects of aging. In perspective, molecular mechanisms underlying social aging should be further explored and related to migraine with a closer association with migraine predisposition and difference in prevalence by sex.
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Affiliation(s)
- Michal Fila
- Department of Developmental Neurology and Epileptology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland.
| | - Elzbieta Pawlowska
- Department of Pediatric Dentistry, Medical University of Lodz, 92-216 Lodz, Poland.
| | - Joanna Szczepanska
- Department of Pediatric Dentistry, Medical University of Lodz, 92-216 Lodz, Poland.
| | - Janusz Blasiak
- Department of Molecular Genetics, University of Lodz, Pomorska 141/143, 90-236, Lodz, Poland.
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Pavlou M, Costafreda SG, Galsworthy W, Korres G, Bamiou DE. The interplay between cognition, functional and dual-task gait in persons with a vestibular disorder versus healthy controls. Sci Rep 2023; 13:10130. [PMID: 37349351 PMCID: PMC10287746 DOI: 10.1038/s41598-023-35904-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
Close links exist between vestibular function and cognition. Dual-task (DT) tests may have ecological validity to assess the impact of daily life cognitive-motor demands in people with vestibular dysfunction (PwVD), functional gait and falls risk. The present paper aimed at building predictive models for functional gait under DT conditions, while clarifying the impact of vestibular dysfunction, individual characteristics, varying task types and motor-cognitive demands. Case-controlled observational study with 39 PwVD and 62 healthy participants. The Functional Gait Assessment (FGA), with and without an additional motor, numeracy, or literacy task, was completed. Multiple linear regression was used to fit models to predict FGA under single and DT performance. Dual task cost (DTC, %) was calculated to assess DT interference on FGA performance using the equation: 100*(single task score-dual task score)/single-task score. Following Bonferroni corrections for multiple comparisons (corrected alpha level of 0.003), PwVD had poorer performance than controls for all FGA conditions (p < 0.001), motor (- 3.94%; p = 0.002) and numeracy (- 22.77%; p = 0.001) DTCs and spatial working memory (p = 0.002). The literacy DTC was marginally significant (- 19.39% p = 0.005). FGA single and DT motor, numeracy, and literacy models explained 76%, 76%, 66% and 67% of the variance respectively for PwVD. Sustained attention, visual memory and sex contributed to all models; short-term visual recognition memory, balance confidence, and migraine contributed to some models. Cognitive performance is impaired in PwVD. Motor, numeracy and literacy tasks impair functional gait performance. Cognitive assessment and FGA with a numeracy or literacy cognitive component should be included within assessment protocols and considered in the provision of targeted interventions for PwVD.
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Affiliation(s)
- Marousa Pavlou
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, Shepherd's House, Guy's Campus, London, SE1 1UL, UK.
- Department of Neuro-Otology, University College London Hospitals, London, UK.
| | - Sergi G Costafreda
- Biomedical Research Centre, University College London Hospitals, London, UK
| | - William Galsworthy
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, Shepherd's House, Guy's Campus, London, SE1 1UL, UK
| | - George Korres
- Department of Neuro-Otology, University College London Hospitals, London, UK
| | - Doris-Eva Bamiou
- Department of Neuro-Otology, University College London Hospitals, London, UK
- Ear Institute, University College London, London, UK
- Biomedical Research Centre, University College London Hospitals, London, UK
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6
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González-Mingot C, Gil-Sánchez A, Canudes-Solans M, Peralta-Moncusi S, Solana-Moga MJ, Brieva-Ruiz L. Preventive treatment can reverse cognitive impairment in chronic migraine. J Headache Pain 2022; 23:121. [PMID: 36109696 PMCID: PMC9476561 DOI: 10.1186/s10194-022-01486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To study the impact of chronic migraine (CM) on the cognition and quality of life (QoL) of patients in the interictal period, and to analyse the degree of reversibility of any observed alterations following the use of preventive treatment.
Background
CM is a highly disabling disease, and migraineurs often have associated comorbidities, such as subjective memory problems, that are involved in the development of cognitive impairment. Our hypotheses are that patients suffering from chronic migraine experience objective cognitive alterations that are not only due to the pain that they suffer or their current emotional state. Furthermore, preventive treatment should be capable of reversing, or at least reducing, the impact of CM on the cognition and QoL of migraineurs.
Methods
The cognition and QoL of 50 control subjects and 46 patients with CM were assessed using a battery of tests, prior to the use of preventive treatment based on botulinum toxin or oral drugs and after 3 months of this treatment.
Results
Compared with controls, patients with CM had lower scores on the assessment of cognitive performance (Rey-Osterrieth Complex Figure test [ROCF] (p<0.05), Trail Making Test [TMT] B) (p < 0.05) and QoL (p < 0.05). Three months after the use of preventive treatment, improvement was observed in all cognitive parameters (p < 0.05) and QoL (p < 0.05), except the ROCF copy task (p = 0.79). No statistically significant differences were observed when these outcomes were compared based on treatment.
Conclusions
This study confirms poor cognitive performance that is not explained by migraine pain itself, as it occurs in the interictal period, irrespective of the patient’s emotional status. Our findings show that these effects are reversible in some cases with preventive treatment of CM, reaffirming the important impact of this condition on the QoL of these patients, and the need to establish preventive treatment guidelines.
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Hakamäki H, Jehkonen M. Neuropsychological findings in migraine: a systematic review. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT. Patients with migraine often experience cognitive dysfunction during a migraine attack, but they have also been reported to complain about cognitive impairment after an attack and during the interictal period. Objective: The aim of this study was to determine what neuropsychological test methods are used to assess cognitive functioning in migraine patients and to examine the neuropsychological findings in adult (≥18 years) migraineurs compared to adult (≥18 years) healthy controls (HC). Methods: A systematic review was conducted on the literature published between 2012 and the present. The search results were screened and additional studies identified in the lists of references in the selected articles. A total of 16 articles met the inclusion criteria. Results: The 16 articles included in the review compared chronic migraineurs (CM), migraineurs with (MwA) and without aura (MwoA), and migraineurs without aura classification (MIG) to HC. A total of 45 neuropsychological assessment methods were identified. CM and MwA were found to perform significantly worse than HC in executive function, attention, and visual functioning. Additionally, both MwA and MwoA performed significantly worse than HC in memory functions. CM and both MwA and MwoA also performed significantly worse than HC in general cognitive functioning. Surprisingly, MIG performed significantly better than HC in several cognitive domains, including executive, motor, and language functioning and general cognitive functioning. Conclusions: This systematic review mostly concurs with the results of an earlier systematic review on the topic from 2012, but with the important addition that different migraine diagnostic groups should be assessed separately.
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Affiliation(s)
| | - Mervi Jehkonen
- Tampere University, Finland; Tampere University Hospital, Finland
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8
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Increased risk of all-cause, Alzheimer's, and vascular dementia in adults with migraine in Korea: a population-based cohort study. J Headache Pain 2022; 23:108. [PMID: 36002812 PMCID: PMC9404580 DOI: 10.1186/s10194-022-01484-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies investigating the association between migraine and dementia have reported inconsistent findings. This study aimed to evaluate whether patients with migraine have an increased risk of dementia compared to individuals without migraine. METHODS We obtained data from the 2002-2019 Korean National Health Insurance Health Screening Cohort. Non-migraine controls were selected using a 1:1 risk-set matching with a time-dependent propensity score. The main outcome was the development of all-cause dementia, and the secondary outcome was the development of each cause of dementia (Alzheimer's, vascular, mixed or other specified, and unspecified dementia). The incidence rate of dementia was calculated using Poisson regression, and the association between migraine and dementia was evaluated using Cox proportional hazards regression. RESULTS Among 88,390 participants, 66.1% were female, and the mean baseline age was 55.3 ± 9.4 years. During the study period, dementia cases were identified in 4,800 of the 44,195 patients with migraine and 3,757 of the 44,915 matched controls. The incidence rate of dementia was 139.6 (95% confidence interval [CI], 135.7-143.5) and 107.7 (95% CI, 104.3-111.1) cases per 10,000 person-years in patients with migraine and matched controls, respectively. Patients with migraine had a 1.30 (hazard ratio [HR], 1.30; 95% CI, 1.25-1.35), 1.29 (HR, 1.29; 95% CI, 1.23-1.35), 1.35 (HR, 1.35; 95% CI, 1.19-1.54), 1.36 (HR, 1.36; 95% CI, 1.00-1.83), and 1.30 (HR, 1.30; 95% CI, 1.17-1.45) times higher risk of developing all-cause dementia, Alzheimer's dementia, vascular dementia, mixed or other specified dementias, and unspecified dementia than their matched controls, respectively. CONCLUSION Our results suggest that migraine is associated with an increased risk of subsequent dementia. Further research is warranted to confirm these findings and to reveal the underlying mechanisms.
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Gu L, Wang Y, Shu H. Association between migraine and cognitive impairment. J Headache Pain 2022; 23:88. [PMID: 35883043 PMCID: PMC9317452 DOI: 10.1186/s10194-022-01462-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background Previous studies revealed inconsistent results regarding association between migraine and cognitive impairment. In addition, previous studies found inconsistent results regarding the association between migraine and risk of dementia. Thus, the study aimed to make a meta-analysis exploring comparison result in different types of cognitive function between migraine patients and non-migraine subjects. In addition, meta-analysis was made to explore the association between migraine and risk of dementia. Methods Articles published before June 2022 were searched in the following databases: PubMed, Web of Science, SCOPUS, EMBASE, EBSCO, PROQUEST, ScienceDirect and Cochrane Database of Systematic Reviews. Results were computed using STATA 12.0 software. Results Meta-analysis showed lower general cognitive function and language function in migraine group, compared to no migraine group (general cognitive function: standard mean difference (SMD) = − 0.40, 95% CI = − 0.66 to − 0.15; language: SMD = − 0.14, 95% confidence interval (CI) = − 0.27 to − 0.00), whereas the study showed no significant difference in visuospatial function, attention, executive function and memory between migraine group and no migraine group (visuospatial function: SMD = − 0.23, 95% CI = − 0.53 to 0.08; attention: SMD = − 0.01, 95% CI = − 0.10 to 0.08; executive function: SMD = − 0.05, 95% CI = − 0.16 to 0.05; memory: SMD = − 0.14, 95% CI = − 0.30 to 0.03). In addition, the meta-analysis showed a significant association between migraine and risk of dementia (odds ratio (OR)/relative risk (RR) = 1.30, 95% CI = 1.11 to 1.52). Conclusions In conclusion, the meta-analysis demonstrated lower general cognitive function and language function in migraine. In addition, migraine is associated with an increased risk of all-cause dementia, VaD and AD. These results suggest a significant association between migraine and cognitive impairment. Because of the association between migraine and cognitive impairment, neurological physician should be vigilant and effectively intervene in migraineurs with high risk factors of cognitive impairment to prevent the development of cognitive impairment. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01462-4.
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Affiliation(s)
- Lihua Gu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China. .,Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.
| | - Yanjuan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
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Liang Y, Gao Y, Wang R, Grande G, Monastero R, Dong Y, Jiang X, Lv P, Qiu C. Migraine, Cognitive Decline, and Dementia in Older Adults: A Population-Based Study. J Alzheimers Dis 2022; 88:263-271. [DOI: 10.3233/jad-220013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: The potential impact of migraine on cognitive aging among older adults remains controversial. Objective: To examine the relationship of migraine and subtypes with cognitive decline and dementia in an older Swedish population. Methods: This population-based study included 3069 participants (age≥60) from the Swedish National study on Aging and Care in Kungsholmen, Stockholm. Baseline examination was conducted in 2001–2004, and participants were followed every 3 or 6 years until 2013–2016. Data were collected through face-to-face interviews, clinical examinations, laboratory tests, and linkage with registers. Global cognitive function was measured with the Mini-Mental State Examination (MMSE). Dementia was diagnosed according to the DSM-IV criteria. Migraine and subtypes were defined following the international classification system. Data were analyzed using logistic regression, Cox regression, and linear mixed-effects models. Results: At baseline, 305 participants were defined with non-migraine headache and 352 with migraine. The cross-sectional analysis showed that the multivariable-adjusted odds ratio (95% confidence interval) of prevalent dementia was 0.49 (0.20–1.21) for migraine and 0.66 (0.26–1.66) for migraine without aura. The longitudinal analysis showed that the multivariable-adjusted hazard ratios of incident dementia associated with migraine and subtypes ranged 0.68–0.89 (p > 0.05). Furthermore, migraine and subtypes were not significantly associated with either baseline MMSE score or MMSE changes during follow-ups (p > 0.05). The nonsignificant associations did not vary substantially by age, APOE ɛ4 allele, cerebrovascular disease, and antimigraine treatment (p for interactions > 0.05). Conclusion: This study shows no evidence supporting the associations of migraine and its subtypes with cognitive decline and dementia among older adults.
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Affiliation(s)
- Yajun Liang
- Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ya Gao
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Rui Wang
- Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
- Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Giulia Grande
- Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xin Jiang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Peiyuan Lv
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Chengxuan Qiu
- Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Begasse de Dhaem O, Robbins MS. Cognitive Impairment in Primary and Secondary Headache Disorders. Curr Pain Headache Rep 2022; 26:391-404. [PMID: 35239156 PMCID: PMC8891733 DOI: 10.1007/s11916-022-01039-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review To critically evaluate the recent literature on cognitive impairment and headache. Recent Findings Neurocognitive symptoms are prevalent, debilitating, and occur often with both primary and secondary headache disorders. Summary This is a “narrative review of the current literature in PubMed on cognitive function and headache.” Migraine is associated with cognitive impairment years before a migraine diagnosis. In young and middle-aged adults, migraine is associated with deficits in attention, executive function, processing speed, and memory. It is unlikely that migraine is associated with dementia. Although methodologically difficult to assess, there does not seem to be an association between tension-type headache and cognitive dysfunction. In early to midlife, cluster headache seems to be associated with executive dysfunction. Several secondary headache syndromes relevant to clinicians managing headache disorders are associated with poorer cognitive performance or distinctive cognitive patterns, including those attributed to chronic cerebral or systemic vascular disorders, trauma, and derangements of intracranial pressure and volume, including frontotemporal brain sagging syndrome.
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Affiliation(s)
| | - Matthew S Robbins
- Department of Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA
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12
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Eikermann-Haerter K, Huang SY. White Matter Lesions in Migraine. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:1955-1962. [PMID: 33636178 DOI: 10.1016/j.ajpath.2021.02.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/16/2021] [Accepted: 02/12/2021] [Indexed: 12/20/2022]
Abstract
Migraine, the third most common disease worldwide, is a well-known independent risk factor for subclinical focal deep white matter lesions (WMLs), even in young and otherwise healthy individuals with no cardiovascular risk factors. These WMLs are more commonly seen in migraine patients with transient neurologic symptoms preceding their headaches, the so-called aura, and those with a high attack frequency. The pathophysiology of migraine-related deep white matter hyperintensities remains poorly understood despite their prevalence. Characteristic differences in their distribution related to chronic small vessel ischemic disease compared with that of common periventricular WMLs in the elderly suggest a different underlying mechanism. Both ischemic and inflammatory mechanisms have been proposed, as there is increased cerebral vulnerability to ischemia in migraineurs, whereas there is also evidence of blood-brain barrier disruption with associated release of proinflammatory substances during migraine attacks. An enhanced susceptibility to spreading depolarization, the electrophysiological event underlying migraine, may be the mechanism that causes repetitive episodes of cerebral hypoperfusion and neuroinflammation during migraine attacks. WMLs can negatively affect both physical and cognitive function, underscoring the public health importance of migraine, and suggesting that migraine is an important contributor to neurologic deficits in the general population.
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Affiliation(s)
| | - Susie Y Huang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and the Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts
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Martins IP, Maruta C, Alves PN, Loureiro C, Morgado J, Tavares J, Gil-Gouveia R. Cognitive aging in migraine sufferers is associated with more subjective complaints but similar age-related decline: a 5-year longitudinal study. J Headache Pain 2020; 21:31. [PMID: 32264821 PMCID: PMC7137205 DOI: 10.1186/s10194-020-01100-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/20/2020] [Indexed: 01/19/2023] Open
Abstract
Objectives and background The effect of headache on cognitive performance is controversial, due to conflicting results obtained from studies in clinical or population settings. We aimed to understand if migraine and other headaches modify the rates of decline on different cognitive measures, during a 5-year interval. Design and method A cohort of community dwelling adults (> 50 years) with migraine (MH), non-migraine headaches (NMH) and controls without headache (WoH), was assessed by a comprehensive neuropsychological battery with tests of memory, language and executive functions, repeated 5 years apart. Change in performance between baseline and reevaluation was compared between groups, and controlled for age, gender, literacy and depressive symptoms. Results A total of 275 participants (78.5% WoH, 12.7% MH, 8.7% NMH) were reevaluated (average age 70.40 + 8.34 years, 64% females). Cognitive decline or dementia occurred in 11.4%, with a similar proportion among the three groups. Although MH participants had significantly more subjective cognitive complaints (p = 0.030, 95%CI:]-3.929,-0.014[), both MH and NMH subjects showed an age-associated decline identical to controls. Furthermore, migraine features (disease and attack duration, frequency and aura) were unrelated with cognitive performance. Conclusion Migraine and non-migraine headache are not associated with increasing risk of dementia or cognitive decline at an older age although subjects with migraine have more cognitive complaints. Longer longitudinal studies are necessary to understand if this pattern persists for more than 5 years.
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Affiliation(s)
- Isabel Pavão Martins
- Departamento de Neurociências e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte - Hospital de Santa Maria, Lisboa, Portugal. .,Laboratório de Estudos de Linguagem, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa Portugal, Av Professor Egas Moniz, Lisboa, Portugal.
| | - Carolina Maruta
- Laboratório de Estudos de Linguagem, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa Portugal, Av Professor Egas Moniz, Lisboa, Portugal.,Universidade Católica Portuguesa, Católica Research Centre for Psychological - Family and Social Wellbeing, Lisboa, Portugal
| | - Pedro Nacimento Alves
- Departamento de Neurociências e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte - Hospital de Santa Maria, Lisboa, Portugal.,Laboratório de Estudos de Linguagem, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa Portugal, Av Professor Egas Moniz, Lisboa, Portugal
| | - Clara Loureiro
- Laboratório de Estudos de Linguagem, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa Portugal, Av Professor Egas Moniz, Lisboa, Portugal
| | - Joana Morgado
- Serviço de Neurologia, Hospital Beatriz Angelo, Loures, Lisboa, Portugal
| | - Joana Tavares
- Serviço de Imagiologia, Hospital de Santa Maria, Lisboa, Portugal
| | - Raquel Gil-Gouveia
- Departamento de Neurociências e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte - Hospital de Santa Maria, Lisboa, Portugal.,Headache Center, Hospital da Luz, Lisboa, Portugal
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KARAHAN ÖZCAN R, ÖZMEN S. Kadın migren hastalarında bilişsel esneklik: vaka-kontrol çalışması. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.654189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
BACKGROUND Migraine is a complex neurological disorder that affects a significant percentage of the human species, from all geographic areas and cultures. Cognitive symptoms and dysfunctions are interim and disabling components of this disorder and may be related to the brain processes underlying the pathophysiology. Yet they are often undervalued by clinicians. In this review, we present the different types of cognitive dysfunctions associated with migraine and the mechanisms that are potentially causing them. FINDINGS While reversible attack-related cognitive dysfunction seems extremely consistent and likely related to functional cortical and subcortical brain changes occurring during attacks, interictal cognitive dysfunction is less consistent and might become more relevant as attack frequency and disease complexity increase. Migraine traits do not seem a predisposition to long-term cognitive decline. Cognitive dysfunction is a frequent manifestation of migraine attacks and may be specific to this disorder; it is important to understand if it could be useful in migraine diagnosis. Attack-related cognitive dysfunction is clinically relevant and contributes to disability, so it should be perceived as a therapeutic target. While there is no evidence to support that migraine increases the risk of long-term or persistent cognitive dysfunction, the fact that it occurs during the attacks and may persist in subjects with frequent or complicated attacks should prompt the understanding of the mechanisms related to its pathophysiology for it may also clarify the processes underlying migraine.
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Begasse de Dhaem OAJ, French J, Morrison C, Meador KJ, Hesdorffer DC, Cristofaro S, Minen MT. Migraine comorbidity and cognitive performance in patients with focal epilepsy. Epilepsy Behav 2019; 97:29-33. [PMID: 31181426 PMCID: PMC6864730 DOI: 10.1016/j.yebeh.2019.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/21/2019] [Accepted: 05/08/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Migraine and epilepsy are comorbid conditions. While it is well known that epilepsy can have an impact on cognitive abilities, there is conflicting evidence in the literature on the relationship between migraine and cognitive function. The aim of this study was to assess whether migraine comorbidity in patients with newly diagnosed focal epilepsy is associated with cognitive dysfunction. METHODS This is a post hoc analysis of data prospectively collected for the Human Epilepsy Project (HEP). There were 349 participants screened for migraine with the 13 questions used in the American Migraine Prevalence and Prevention (AMPP) study. Participants were also screened for depression using the Neurological Disorder Depression Inventory for Epilepsy (NDDI-E) and the Center for Epidemiologic Studies Depression Scale (CES-D) and for anxiety using the Generalized Anxiety Disorder-7 (GAD-7) scale. Cognitive performance was assessed with the Cogstate Brief Battery and Aldenkamp-Baker Neuropsychological Assessment Schedule (ABNAS). RESULTS About a fifth (21.2%) of patients with a new diagnosis of focal epilepsy screened positive for migraine. There were more women and less participants employed full time among the participants with comorbid migraine. They reported slightly more depressive and anxious symptoms than the participants without migraine. Migraine comorbidity was associated with ABNAS memory score (median: 2, range: 0-12, Mann Whitney U p-value: 0.015). However, migraine comorbidity was not associated with Cogstate scores nor ABNAS total scores or other ABNAS domain scores. In linear regressions, depression and anxiety scores were associated with the ABNAS memory score. CONCLUSION In this study, there was no association between migraine comorbidity and objective cognitive scores in patients with newly diagnosed focal epilepsy. The relationship between migraine comorbidity and subjective memory deficits seemed to be mediated by the higher prevalence of depression and anxiety symptoms in patients with epilepsy with comorbid migraine.
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Affiliation(s)
- Olivia A J Begasse de Dhaem
- New York Presbyterian Hospital Columbia University, 710 W 168th Street, 14th Floor, Ericka Ayala's Office, New York, NY 10032, USA.
| | - Jacqueline French
- New York University School of Medicine, NYU Langone Comprehensive Epilepsy Center, 223 East 34th Street, New York, NY 10016, USA
| | - Chris Morrison
- New York University School of Medicine, NYU Langone Comprehensive Epilepsy Center, 223 East 34th Street, New York, NY 10016, USA
| | - Kimford J Meador
- Stanford University Neuroscience Health Center, 213 Quarry Rd Rm 2851, MC 5957, Palo Alto, CA 94304, USA
| | - Dale C Hesdorffer
- Gertrude H.K Sergievsky Center and Department of Epidemiology, Columbia University, 630 West 168th Street, P & S unit 16, PH19, Room 308, New York, NY 10032, USA
| | - Sabrina Cristofaro
- New York University School of Medicine, NYU Langone Comprehensive Epilepsy Center, 223 East 34th Street, New York, NY 10016, USA
| | - Mia T Minen
- New York University School of Medicine, NYU Langone Headache Center, 222 East 41st Street, New York, NY 10017, USA
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Baschi R, Monastero R, Cosentino G, Costa V, Giglia G, Fierro B, Brighina F. Visuospatial learning is fostered in migraine: evidence by a neuropsychological study. Neurol Sci 2019; 40:2343-2348. [DOI: 10.1007/s10072-019-03973-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 06/07/2019] [Indexed: 01/03/2023]
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Abstract
Primary headaches are one of the most prevalent neurological disorders and can occur during a wide range of lifespan. Primary headaches, especially migraine, are cyclic disorders with a complex sequence of symptoms within every headache attack. There is no systematic review of whether these symptoms changes during lifespan. Indeed, the clinical presentation of migraine shows an age-dependent change with a significantly shorter duration of the attacks and occurrence of different paroxysmal symptoms, such as vomiting, abdominal pain or vertigo, in childhood and, in contrast, largely an absence of autonomic signs and a more often bilateral headache in the elderly. The age-dependent differences in the clinical presentation are less distinct in cluster headache and, especially, in tension-type headache. The differences in the clinical presentation are in agreement with the idea that the connectivity of hypothalamic areas with different brainstem areas, especially the central parasympathetic areas, is important for the clinical manifestation of migraine, as well as, the change during lifespan.
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Affiliation(s)
- Andreas Straube
- Department of Neurology, University Hospital LMU, Ludwig-Maximilians-University, 81377, Munich, Germany.
| | - Anna Andreou
- Headache Research, Wolfson CARD, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,The Headache Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Cho SJ, Kim BK, Kim BS, Kim JM, Kim SK, Moon HS, Cha MJ, Park KY, Sohn JH, Chu MK, Song TJ. Associations of Elderly Onset Headache With Occurrence of Poor Functional Outcome, Cardiovascular Disease, and Cognitive Dysfunction During Long-term Follow-up. Ann Geriatr Med Res 2018; 22:176-183. [PMID: 32743270 PMCID: PMC7387621 DOI: 10.4235/agmr.18.0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/08/2018] [Accepted: 10/25/2018] [Indexed: 01/03/2023] Open
Abstract
Background Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods We prospectively enrolled 125 older (≥65 years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28–34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28–12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00–1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01–1.11; p=0.011). Conclusion Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.
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Affiliation(s)
- Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Byung-Kun Kim
- Department of Neurology, Eulji University School of Medicine, Seoul, Korea
| | - Byung-Su Kim
- Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Jae-Moon Kim
- Department of Neurology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Soo-Kyoung Kim
- Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea
| | - Heui-Soo Moon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myoung-Jin Cha
- Department of Neurology, National Police Hospital, Seoul, Korea
| | - Kwang-Yeol Park
- Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jong-Hee Sohn
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea
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Vuralli D, Ayata C, Bolay H. Cognitive dysfunction and migraine. J Headache Pain 2018; 19:109. [PMID: 30442090 PMCID: PMC6755588 DOI: 10.1186/s10194-018-0933-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 10/16/2018] [Indexed: 12/11/2022] Open
Abstract
Cognitive dysfunction has recently gained attention as a significant problem among migraine sufferers. All of the clinical studies show poor cognitive performance during migraine attacks, though, the interictal data are conflicting. Migraineurs show impaired cognitive function interictally in most of the clinic-based studies. Population-based studies did not reveal a difference in cognitive functions between migraineurs and controls. The specific cognitive domains involved are information processing speed, basic attention, executive functions, verbal and non-verbal memory and verbal skills. Neurophysiological, imaging and pharmacological studies support clinical symptoms of cognitive impairment in migraine. Longitudinal studies do not suggest progressive cognitive decline over time in migraine patients. Preventive medications and comorbid disorders such as depression and anxiety can impact cognitive function, but cannot fully explain the cognitive impairment in migraine. In contrast to migraine, tension type or cluster headache are not associated with cognitive impairment, at least during headache-free periods.
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Affiliation(s)
- Doga Vuralli
- Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, 06510, Ankara, Turkey.,Neuropsychiatry Center, Gazi University, Besevler, 06510, Ankara, Turkey
| | - Cenk Ayata
- Neurovascular Research Lab, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Stroke Service, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Hayrunnisa Bolay
- Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, 06510, Ankara, Turkey. .,Neuropsychiatry Center, Gazi University, Besevler, 06510, Ankara, Turkey.
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Selective attention network impairment during the interictal period of migraine without aura. J Clin Neurosci 2018; 60:73-78. [PMID: 30327224 DOI: 10.1016/j.jocn.2018.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 10/03/2018] [Indexed: 10/28/2022]
Abstract
Attention deficits have been demonstrated in migraine patients during the interictal period, but these findings are not consistent across all studies. These inconsistencies may arise due to the different aspects of attention measured by various psychometric tests. Current theories divide attention into three separate domains subserved by separate networks: alerting, orienting, and executive control. The attention network test (ANT) was developed to measure all three attention networks and so may reveal more specific attention deficits among migraineurs. The aim of this study was to evaluate the attention function of migraine without aura (MwoA) patients using a series of neuropsychological scales and the ANT, and to assess the relationships between attention function and headache characteristics (e.g., history, frequency, and duration of each attack). Our results showed that MwoA patients exhibited significantly longer response times (RTs) of the executive control network, whereas no significant differences were observed in alerting and orienting network RTs between groups. MwoA patients also exhibited poorer performance than health control (HC) on the Stroop III and Shape Trail test B (STT B) tests. Spearman's analysis revealed positive correlations between executive control network RTs and both frequency and duration of migraine attack. MwoA patients demonstrate impairments of the executive control network, which appear to be exacerbated by more frequent and longer migraine attacks.
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Tunç A, Tekeşin AK, Güngen BD, Arda E. Cognitive performance in young and middle-aged adults with migraine: Investigating the correlation with white matter hyperintensities and psychological symptoms. Neurol Neurochir Pol 2018; 52:470-476. [PMID: 29778452 DOI: 10.1016/j.pjnns.2018.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/12/2018] [Accepted: 05/02/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study aimed to evaluate the cognitive performance of migraine patients with (MwA) and without aura (MwoA) and investigate the correlation of white matter hyperintensities (WMHs) and psychological symptoms with their cognitive test scores. MATERIAL AND METHODS Hundred migraine patients aged 20-55 years and 80 healthy volunteers with similar age, sex, and education level were enrolled. The total Montreal Cognitive Assessment (MoCA) scores were compared by age, sex, presence of aura, migraine duration, attack frequency, pain localization, presence and number of WMHs, and the scores of the Beck Depression Inventory and the Beck Anxiety Inventory (BAI). RESULTS Forty-seven (47%) patients had MwA and 53 (53%) had MwoA. The performance of the MwA patients was significantly poorer than that of the MwoA patients and the healthy subjects on the MoCA scales. In particular, the results revealed lower scores in the subscales regarding visuospatial/executive functions, naming, memory, attention, and abstraction in MwA patients than in the MwoA patients. Compared to healthy controls, more number of migraine patients had WMHs. The presence and number of WMHs had no significant correlation with the MoCA scores of the migraine patients. There was a significant correlation of the BAI and BDI scores with the total MoCA scores considering all migraine patients. CONCLUSIONS This study suggested that MwA may be associated with low cognitive performance which was correlated with depression and anxiety but not with WMHs. Further, longitudinal studies for assessing the relationship between WMHs, cognitive functions, and migraine, and for establishing the causality are warranted.
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Affiliation(s)
- Abdulkadir Tunç
- Clinic of Neurology, Bezmialem Vakıf University, İstanbul, Turkey.
| | - Aysel Kaya Tekeşin
- Clinic of Neurology, Istanbul Education and Research Hospital, İstanbul, Turkey.
| | | | - Esra Arda
- Clinic of Psychiatry, Istanbul Education and Research Hospital, Istanbul, Turkey.
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Schapira AHV. Advances and insights into neurological practice 2016−17. Eur J Neurol 2017; 24:1425-1434. [DOI: 10.1111/ene.13480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Pellegrino Baena C, Goulart AC, Santos IDS, Suemoto CK, Lotufo PA, Bensenor IJ. Migraine and cognitive function: Baseline findings from the Brazilian Longitudinal Study of Adult Health: ELSA-Brasil. Cephalalgia 2017; 38:1525-1534. [PMID: 29058954 DOI: 10.1177/0333102417737784] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background The association between migraine and cognitive performance is unclear. We analyzed whether migraine is associated with cognitive performance among participants of the Brazilian Longitudinal Study of Adult Health, ELSA-Brasil. Methods Cross-sectional analysis, including participants with complete information about migraine and aura at baseline. Headache status (no headaches, non-migraine headaches, migraine without aura and migraine with aura), based on the International Headache Society classification, was used as the dependent variable in the multilinear regression models, using the category "no headache" as reference. Cognitive performance was measured with the Consortium to Establish a Registry for Alzheimer's Disease word list memory test (CERAD-WLMT), the semantic fluency test (SFT), and the Trail Making Test version B (TMTB). Z-scores for each cognitive test and a composite global score were created and analyzed as dependent variables. Multivariate models were adjusted for age, gender, education, race, coronary heart disease, heart failure, hypertension, diabetes, dyslipidemia, body mass index, smoking, alcohol use, physical activity, depression, and anxiety. In women, the models were further adjusted for hormone replacement therapy. Results We analyzed 4208 participants. Of these, 19% presented migraine without aura and 10.3% presented migraine with aura. All migraine headaches were associated with poor cognitive performance (linear coefficient β; 95% CI) at TMTB -0.083 (-0.160; -0.008) and poorer global z-score -0.077 (-0.152; -0.002). Also, migraine without aura was associated with poor cognitive performance at TMTB -0.084 (-0.160, -0.008 and global z-score -0.077 (-0.152; -0.002). Conclusion In participants of the ELSA-study, all migraine headaches and migraine without aura were significantly and independently associated with poorer cognitive performance.
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Affiliation(s)
- Cristina Pellegrino Baena
- 1 Center for Clinical and Epidemiological Research of the University of São Paulo, São Paulo, Brazil.,2 School of Medicine, Pontifícia Universidade Católica Paraná, Curitiba, Brazil
| | | | - Itamar de Souza Santos
- 1 Center for Clinical and Epidemiological Research of the University of São Paulo, São Paulo, Brazil
| | - Claudia Kimie Suemoto
- 1 Center for Clinical and Epidemiological Research of the University of São Paulo, São Paulo, Brazil.,3 Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- 1 Center for Clinical and Epidemiological Research of the University of São Paulo, São Paulo, Brazil
| | - Isabela Judith Bensenor
- 1 Center for Clinical and Epidemiological Research of the University of São Paulo, São Paulo, Brazil
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Lee SH, Kang Y, Cho SJ. Subjective cognitive decline in patients with migraine and its relationship with depression, anxiety, and sleep quality. J Headache Pain 2017; 18:77. [PMID: 28744704 PMCID: PMC5526827 DOI: 10.1186/s10194-017-0779-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/04/2017] [Indexed: 01/03/2023] Open
Abstract
Background Cognitive decline is a major concern in patients with migraine. Depression, anxiety, and/or poor sleep quality are well-known comorbidities of migraine, but available evidence on the subjective cognitive decline (SCD) is limited. This study aimed to investigate the presence and frequency of SCD and its relationship with anxiety, depression and sleep quality in patients with migraine. Methods We enrolled patients with migraine who scored within the normal range of the Korean-Mini Mental State Examination and the Korean-Montreal Cognitive Assessment. Using the Subjective Cognitive Decline Questionnaire (SCD-Q), participants with ≥7 were assigned to the SCD group. The Headache Impact Test-6, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Pittsburgh Sleep Quality Index were used and analyzed between the two groups. Results A total of 188 patients with migraine, aged 38.1 ± 9.9 years, were enrolled. The mean SCD-Q score was 6.5 ± 5.5, and 44.7% of participants were identified as SCD. Migraineurs with SCD reported higher headache pain intensity and headache impact, as well as greater prevalence of anxiety, depression, reduced quality of sleep, and shorter sleep duration during weekdays compared to migraineurs without SCD. There were no significant differences in terms of age, sex, migraine type (chronic/episodic), medication, or sleep duration during weekends between the two groups. Upon multivariate logistic analysis adjusted for age, sex, headache characteristics, and psychological variables, depression was associated with increased risk of SCD (Odds ratio 1.31, 95% confidence interval 1.16–1.49) and sleep duration during weekdays was associated with decreased risk of SCD (Odds ratio 0.66, 95% confidence interval 0.44–0.97). Conclusions A non-negligible number of patients with migraine complained of SCD. Depression and short sleep duration during weekdays were related to SCD among adult migraineurs.
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Affiliation(s)
- Sun Hwa Lee
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 445-907, South Korea
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chuncheon, Korea
| | - Soo-Jin Cho
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 445-907, South Korea.
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Huang L, Juan Dong H, Wang X, Wang Y, Xiao Z. Duration and frequency of migraines affect cognitive function: evidence from neuropsychological tests and event-related potentials. J Headache Pain 2017; 18:54. [PMID: 28477306 PMCID: PMC5419957 DOI: 10.1186/s10194-017-0758-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the changes in the cognitive performance of migraine patients using a comprehensive series of cognitive/behavioral and electrophysiological tests. METHOD A randomized, cross-sectional, within subject approach was used to compare neuropsychological and electrophysiological evaluations from migrane-affected and healthy subjects. RESULTS Thirty-four patients with migraine (6 males, 28 females, average 36 years old) were included. Migraineurs performed worse in the majority of the Montreal Cognitive Assessment (MoCA) (p = 0.007) compared to the healthy subjects, significantly in language (p = 0.005), memory (p = 0.006), executive functions (p = 0.042), calculation (p = 0.018) and orientation (p = 0.012). Migraineurs had a lower score on the memory trial of the Rey-Osterrieth complex figure test (ROCF) (p = 0.012). The P3 latency in Fz, Cz, Pz was prolonged in migraineurs compared with the normal control group (P < 0.001). In addition, we analyzed significant correlations between MoCA score and the duration of migraine. We also observed that a decrease in the MoCA-executive functions and calculation score and in the ROCF-recall score were both correlated to the frequency of migraine. Migraineurs were more anxious than healthy subjects (p = 0.001), which is independent of cognitive testing. Differences were unrelated to age, gender and literacy. CONCLUSIONS Cognitive performance decreases during migraine, and cognitive dysfunction can be related to the duration and frequency of a migraine attack.
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Affiliation(s)
- Lifang Huang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Hong Juan Dong
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Xi Wang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Yan Wang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Zheman Xiao
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China.
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Pavao Martins I. Better cognition in migraine? Eur J Neurol 2016; 23:1487-8. [PMID: 27456321 DOI: 10.1111/ene.13108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 06/27/2016] [Indexed: 12/15/2022]
Affiliation(s)
- I Pavao Martins
- Faculdade de Medicina, Department of Clinical Neurosciences, Hospital de Santa Maria Lisboa, Universidade de Lisboa, Lisboa, Portugal.
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