Patients with migraine can have cognitive dysfunction at headache onset, which may be severe enough to affect daily functioning, according to researchers.
WASHINGTON, DC—Patients with migraine may experience a significant decline in cognitive function at the onset of a headache attack, according to research presented at the 53rd Annual Scientific Meeting of the American Headache Society.
“Cognitive dysfunction with migraine may be an under-recognized disability associated with migraine, especially when considered independently from the headache intensity,” reported Keith Edwards, MD, Director of Empire Neurology in Latham, New York, and lead researcher of the study.
Assessing Cognitive Dysfunction Associated With Migraine
Many patients with migraine report cognitive-related difficulties such as lack of concentration, difficulty in word finding, or an inability to remember, noted Dr. Edwards. He and his colleagues sought to assess cognitive dysfunction with migraine among 25 patients (mean age, 45) with migraine with or without aura. To establish baseline cognitive values, the patients were instructed to complete a computerized cognitive test while they were asymptomatic. The test measured attention and processing speed, visual-motor response time, visual-spatial skills, working memory, and fine motor skills by four tests (simple reaction time, procedural reaction time, matching-to-sample, and pursuit tracking). Pain and associated migraine symptoms were also recorded.
The patients (all female) then completed the computerized cognitive test at the onset, one hour after, and two hours after migraine attacks. “A total of 46 separate migraine attacks were measured at their onset,” the researchers reported, with most patients completing the assessment for two migraine attacks. “All patients had a statistically significant decline in overall cognitive deficiency as measured by each of the four parameters at the onset of the migraine attack, compared with baseline cognitive function.”
Headache Intensity Not Correlated With Cognitive Dysfunction
Cognitive dysfunction was most severe at the onset of the migraine attack; however, the investigators noted, there was no significant correlation between headache intensity and cognitive dysfunction with migraine severity. “We have not completed the complete statistical analysis, but it looks to me as though there is no correlation between headache severity and cognitive dysfunction,” Dr. Edwards told Neurology Reviews.
“The data show that the intensity of the headache does not determine the level of cognitive disability. Just as the visual aura may be a visual disability for some patients, and then the headache may or may not be severe, some of the patients reported prolonged cognitive dysfunction with only a mild headache.
“We had hoped that this research would raise awareness among treating physicians in general, and headache specialists in particular, of the cognitive disability associated with migraine headache,” Dr. Edwards concluded.
—Ariel Jones