Cognitive impairment in migraine:A systematic review

Araújo, Caroline Martins de; Barbosa, Izabela Guimarães; Lemos, Stela Maris Aguiar; Domingues, Renan Barros; Teixeira, Antonio Lucio

doi:10.1590/S1980-57642012DN06020002

ABSTRACT

Patients with migraine often report cognitive complaints, especially regarding attention and memory.

Objective:

To perform a systematic review of the studies available on cognitive evaluation in patients with migraine.

Methods:

We evaluated all articles containing the key words: "Migraine", "Cognition" and "Cognitive Impairment."

Results:

The search strategy resulted in 23 articles. Fifteen out of the 23 studies (65.3%) retrieved reported abnormalities on neuropsychological tests in migraine patients, notably tests of memory, attention and information processing speed. Most of the studies showing cognitive changes in migraine were carried out in neurological care facilities. Conversely, among community-based studies, migraine patients were less likely to present cognitive changes.

Conclusion:

Patients with migraine, especially those followed at neurology clinics, show an elevated risk of mild changes in several cognitive domains. Further studies with greater methodological refinement are warranted in order to clearly establish whether this cognitive dysfunction is associated with an underlying migraine pathophysiological process.

Key words:
migraine; cognition; cognitive impairment.

RESUMO

Pacientes com migrânea frequentemente se queixam de problemas cognitivos, sobretudo relacionados à memória e à atenção.

Objetivo:

Realizar uma revisão sistemática sobre os estudos com avaliação cognitiva em pacientes com migrânea.

Métodos:

Foram avaliados todos os artigos que incluíram as palavras-chave "Migraine", "Cognition" and "Cognitive Impairment".

Resultados:

Foram encontrados 23 artigos que estudaram desempenho cognitivo em pacientes com migrânea. Dentre estes, quinze (65,3%) relataram alterações em testes neuropsicológicos em pacientes com migrânea, notadamente em testes de memória, atenção e velocidade de processamento. A maioria dos trabalhos que mostraram alterações cognitivas na migrânea foi realizada em serviços neurológicos. Por outro lado, nos estudos de base populacional, essas alterações eram menos comuns.

Conclusão:

Pacientes com migrânea, especialmente os acompanhados em serviços neurológicos, apresentam risco aumentado de comprometimento leve em diferentes domínios cognitivos. Estudos com maior refinamento metodológico são necessários para definir claramente se essas alterações cognitivas estão associadas a processo fisiopatológico subjacente à migrânea.

Palavras-chave:
migrânea; cognição; comprometimento cognitivo.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

REFERENCES

Lipton RB, Stewart WF, Diamond S, Diamond SL, Reed W. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001;41:646-657.
Silva-Junior AA, Faleiros BE, Santos TM, Gomez RS, Teixeira AL. Relative frequency of headache types: A longitudinal study in the tertiary care. Arq Neuropsiquiatr 2010;68:878-881.
Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global burden of disease study. Lancet 1997;349:1436-1442.
Zeitlin C, Oddy M. Cognitive impairment in patients with severe migraine. Br J Clin Psychol 1984;23:27-35.
Hooker WD, Raskin NH. Neuropsychologic alterations in classic and common migraine. Arch Neurol 1986;43:709-712.
Bell BD, Primeau M, Sweet JJ, Lofland KR. Neuropsychological functioning in migraine headache, nonheadache chronic pain, and mild traumatic brain injury patients. Arch Clin neuropsychol 1999;14:389-399.
Le Pira F, Zappala G, Giuffrida S, et al. Memory disturbances in migraine with and without aura:A strategy problem? Cephalalgia 2000;20:475-478.
Meyer JS, Thornby J, Crawford K, Rauch GM. Reversible cognitive decline accompanies migraine and cluster headaches. Headache 2000; 40:638-646.
Calandre EP, Bembibre J, Arnedo ML, Becerra D. Cognitive disturbances and regional cerebral blood flow abnormalities in migraine patients: their relationship with the clinical manifestations of the illness. Cephalalgia 2002;22:291-302.
Le Pira F, Lanaia F, Zappala G, et al. Relationship between clinical variables and cognitive performances in migraineurs with and without aura. Funct Neurol 2004;19:101-105.
Mongini F, Keller R, Deregibus A, Barbalonga E, Mongini T. Frontal lobe dysfunction in patients with chronic migraine:a clinical-neuropsychological study. Psychiatry Res 2005;133:101-106.
Pearson AJ, Chronicle EP, Maylor EA, Bruce LA. Cognitive function is not impaired in people with a long history of migraine: A blinded study. Cephalagia 2005;26:74-80.
Camarda C, Monastero R, Pipia C, Recca D, Camarda R. Interictal executive dysfunction in migraineurs without aura:relationship with duration and intensity of attacks. Cephalalgia 2007;27:1094-1100.
Schmitz N, Arkink EB, Mulder M, et al. Frontal lobe structure and executive function in migraine patients. Neurosci Lett 2008;440:92-96.
Burker E, Hannay H, Halsey JH. Neuropsychological functioning and personality characteristics of migrainous and nonmigrainous female college students. Neuropsychology 1989;3:61-73.
Leijdekkers ML, Passchier J, Goudswaard P, Menges LJ, Orlebeke JF. Migraine patients cognitively impaired? Headache 1990;30:352-358.
Mulder EJ, Linssen WH, Passchier J, Orlebeke JF, de Geus EJ. Interictal and postictal cognitive changes in migraine. Cephalalgia 1999;19:557-565.
Jelicic M, van Boxtel PJ, Houx PJ, Jolles J. Does migraine headache affect cognitive function in the elderly? Report from the Maatricht Aging Study. Headache 2000;40:715-719.
Gaist D, Pedersen L, Madsen C, et al. Long-term effects of migraine on cognitive function:a population based study of Danish twins. Neurology 2005;64:600-607.
Mckendrick AM, Badcock DR, Badcock JC, Gurgone M. Motion perception in migraineurs:abnormalities are not related to attention. Cephalalgia 2006;26:1131-1136.
D'Andrea G, Nertempi P, Ferro-Milone F, Joseph R, Cananzi AR. Personality and memory in childhood migraine. Cephalalgia 1989;9:25-28.
Haverkamp F, Hönscheid A, Müller-Sinik K. Cognitive development in children with migraine and their healthy unaffected siblings. Headache 2002;42:776-779.
Parisi P, Verrotti A, Paolino MC, et al. Headache and cognitive profile in children:a cross-sectional controlled study. Headache 2010;11:45-51.
Moutran ARC, Villa TR, Diaz LAS, et al.. Migraine and cognition in children; a controlled study. Arq Neuropsiquiatr 2011;69:192-195.
Waldie KE, Hausmann M, Milne BJ, Poulton R. Migraine and cognitive function: A life-course study. Neurology 2002;59:904-908.
Riva D, Aggio F, Vago C, et al. Cognitive and behavioural effects of migraine in childhood and adolescence. Cephalalgia 2006;26:596-603.
Baars MAE, Boxtel MPJ, Jolles J. Migraine does not affect cognitive decline: results from the Maastricht aging study. Headache 2010;50: 176-184.
Farmer K, Cady R, Reeves D. A pilot study to measure cognitive efficiency during migraine. Headache 2000;40:657-661.
Farmer K, Cady R, Reeves D. The effect of prodrome on cognitive efficiency. Headache 2003;43:518.
Porter A, Gladstone JP, Dodick DW. Migraine and white matter hyperintensities. Curr Pain Head Rep 2005;9:289-293.
Kurth T, Mohamed S, Maillard P, et al. Headache , migraine, and structural brain lesions and function:population based epidemiology of vascular Ageing-MRI study. BMJ 2011;18-342.
Calandre EP, Bembibre J, Arnedo ML, Becerra D. Cognitive disturbances and regional cerebral blood flow abnormalities in migraine patients:Their relationship with the clinical manifestations of the illness. Cephalalgia 2002;22:291-302.
Schmitz N, Arkink EB, Mulder M, et al. Frontal lobe structure and executive function in migraine patients. Neurosci Lett 2008;440:92-96.
Karner E, Delazer M, Benke T, Bösch S. Cognitive Functions, Emotional Behavior and quality of life in familial hemiplegic migraine. Cog Behav Neurol 2010;23:106-111.
Martins IP, Cunha-Sá M. Loss of topographic memory and prosopagnosia during migraine aura. Cephalalgia 1999;19:841-843.
Hadjikhani N, Sanchez Del Rio M, Wu O, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci U S A 2001;98:4687-4692.
Schürks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. Migraine and cardiovascular disease:systematic review and meta-analysis. BMJ 2009;339:b3914.
O'Bryant SE, Marcus DA, Rains JC, Penzien DB. The neuropsychology of reccurent headache. Headache 2006;46:1364-1376.
Idiazábal MA, Palencia-Taboada AB, Sangorrin J, Espadaler-Gamissans JM. Potenciales evocados cognitivos em El transtorno por déficit de atención com hiperatividad. Rev Neurol (Barcelona) 2002;34:301-305.
Shochat E, Scheuer CI, Andrade ER. ABR and auditory P300 findings in clhildren with ADHD. Arq Neuropsiquiatr 2002;60:742-747.
Farias LS, Toniolo IF, Cóser PL. P300: avaliação eletrofisiológica da audição em crianças sem e com repetência escolar. Rev Bras Otorrinolaringolol 2004;70:194-199.
Drake ME, Pakalnis A, Padamadan H. Long-latency auditory event related potentials in migraine. Headache 1989;29:239-241.
Siniatchkin M, Kropp P, Gerber WD. What kind of habituation is impaired in migraine patients? Cephalalgia 2003;23:511-518.
Merikangas KR, Risch NJ, Merikangas JR, Weissman MM, Kidd KK. Migraine and depression:association and familial transmission. J Psychiatric Res 1988;22:119-129.
Merikangas KR, Merikangas JR, Angst J. Headache syndromes and psychiatric disorders:association and familial transmission. J Psychiatric Res 1993;27:197-210.
Brandt J, Celentano D, Steward WF, Linet M, Folstein MF. Personality and emotional disorders in a community sample of migraine headache sufferers. Am J Psychiatry 1990;147:303-308.
Breslau N, Davis GC, Andreski P. Migraine, psychiatric disorders, and suicide attempts:an epidemiologic study of young adults. Psychiatry Res 1991;37:11-23
Breslau N, Andreaski P. Migraine, personality, and psychiatric comorbidity. Headache 1995;35:382-386.
Rasmussen BK. Migraine and tension-type headache in a general population:psychosocial factors. Int J Epidemiol 1992;21:1138-1143.
Merikangas KR. Psychopathology and headache syndromes in the community. Headache 1994;34:S17-S22.
Peres MF, Mercante JP, Tanuri FC, Nunes M, Zukerman E. Chronic migraine prevention with topiramate. J Head Pain 2006;7:185-187.
Suhr JA, Seng EK. Neuropsychological functioning in migraine: clinical and research implications. Cephalalgia . 2012;32:39-54.
Láinez MJ, Freitaq FG, Pfeil J, Ascher S, Olson WH, Schwalen S. Time course of adverse events most commonly associated with topiramate for migraine prevention. Eur J Neurol. 2007;14:900-906.
Romigi A, Cervellino A, Marciani MG, et al. Cognitive and psychiatric effects of topiramate monotherapy in migraine treatment:an open study. Eur J Neurol 2008;15:190-195.
Krymchantowski AC, Jevoux CC. Condutas práticas em cefaléia e dores craniofaciais. São Paulo, Lippincott Williams & Wilkins; 2006:238.

Publication Dates

Publication in this collection
Apr-Jun 2012

History

Received
16 Mar 2011
Accepted
17 May 2012

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] Lipton RB, Stewart WF, Diamond S, Diamond SL, Reed W. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001;41:646-657.

[2] Silva-Junior AA, Faleiros BE, Santos TM, Gomez RS, Teixeira AL. Relative frequency of headache types: A longitudinal study in the tertiary care. Arq Neuropsiquiatr 2010;68:878-881.

[3] Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global burden of disease study. Lancet 1997;349:1436-1442.

[4] Zeitlin C, Oddy M. Cognitive impairment in patients with severe migraine. Br J Clin Psychol 1984;23:27-35.

[5] Hooker WD, Raskin NH. Neuropsychologic alterations in classic and common migraine. Arch Neurol 1986;43:709-712.

[6] Bell BD, Primeau M, Sweet JJ, Lofland KR. Neuropsychological functioning in migraine headache, nonheadache chronic pain, and mild traumatic brain injury patients. Arch Clin neuropsychol 1999;14:389-399.

[7] Le Pira F, Zappala G, Giuffrida S, et al. Memory disturbances in migraine with and without aura:A strategy problem? Cephalalgia 2000;20:475-478.

[8] Meyer JS, Thornby J, Crawford K, Rauch GM. Reversible cognitive decline accompanies migraine and cluster headaches. Headache 2000; 40:638-646.

[9] Calandre EP, Bembibre J, Arnedo ML, Becerra D. Cognitive disturbances and regional cerebral blood flow abnormalities in migraine patients: their relationship with the clinical manifestations of the illness. Cephalalgia 2002;22:291-302.

[10] Le Pira F, Lanaia F, Zappala G, et al. Relationship between clinical variables and cognitive performances in migraineurs with and without aura. Funct Neurol 2004;19:101-105.

[11] Mongini F, Keller R, Deregibus A, Barbalonga E, Mongini T. Frontal lobe dysfunction in patients with chronic migraine:a clinical-neuropsychological study. Psychiatry Res 2005;133:101-106.

[12] Pearson AJ, Chronicle EP, Maylor EA, Bruce LA. Cognitive function is not impaired in people with a long history of migraine: A blinded study. Cephalagia 2005;26:74-80.

[13] Camarda C, Monastero R, Pipia C, Recca D, Camarda R. Interictal executive dysfunction in migraineurs without aura:relationship with duration and intensity of attacks. Cephalalgia 2007;27:1094-1100.

[14] Schmitz N, Arkink EB, Mulder M, et al. Frontal lobe structure and executive function in migraine patients. Neurosci Lett 2008;440:92-96.

[15] Burker E, Hannay H, Halsey JH. Neuropsychological functioning and personality characteristics of migrainous and nonmigrainous female college students. Neuropsychology 1989;3:61-73.

[16] Leijdekkers ML, Passchier J, Goudswaard P, Menges LJ, Orlebeke JF. Migraine patients cognitively impaired? Headache 1990;30:352-358.

[17] Mulder EJ, Linssen WH, Passchier J, Orlebeke JF, de Geus EJ. Interictal and postictal cognitive changes in migraine. Cephalalgia 1999;19:557-565.

[18] Jelicic M, van Boxtel PJ, Houx PJ, Jolles J. Does migraine headache affect cognitive function in the elderly? Report from the Maatricht Aging Study. Headache 2000;40:715-719.

[19] Gaist D, Pedersen L, Madsen C, et al. Long-term effects of migraine on cognitive function:a population based study of Danish twins. Neurology 2005;64:600-607.

[20] Mckendrick AM, Badcock DR, Badcock JC, Gurgone M. Motion perception in migraineurs:abnormalities are not related to attention. Cephalalgia 2006;26:1131-1136.

[21] D'Andrea G, Nertempi P, Ferro-Milone F, Joseph R, Cananzi AR. Personality and memory in childhood migraine. Cephalalgia 1989;9:25-28.

[22] Haverkamp F, Hönscheid A, Müller-Sinik K. Cognitive development in children with migraine and their healthy unaffected siblings. Headache 2002;42:776-779.

[23] Parisi P, Verrotti A, Paolino MC, et al. Headache and cognitive profile in children:a cross-sectional controlled study. Headache 2010;11:45-51.

[24] Moutran ARC, Villa TR, Diaz LAS, et al.. Migraine and cognition in children; a controlled study. Arq Neuropsiquiatr 2011;69:192-195.

[25] Waldie KE, Hausmann M, Milne BJ, Poulton R. Migraine and cognitive function: A life-course study. Neurology 2002;59:904-908.

[26] Riva D, Aggio F, Vago C, et al. Cognitive and behavioural effects of migraine in childhood and adolescence. Cephalalgia 2006;26:596-603.

[27] Baars MAE, Boxtel MPJ, Jolles J. Migraine does not affect cognitive decline: results from the Maastricht aging study. Headache 2010;50: 176-184.

[28] Farmer K, Cady R, Reeves D. A pilot study to measure cognitive efficiency during migraine. Headache 2000;40:657-661.

[29] Farmer K, Cady R, Reeves D. The effect of prodrome on cognitive efficiency. Headache 2003;43:518.

[30] Porter A, Gladstone JP, Dodick DW. Migraine and white matter hyperintensities. Curr Pain Head Rep 2005;9:289-293.

[31] Kurth T, Mohamed S, Maillard P, et al. Headache , migraine, and structural brain lesions and function:population based epidemiology of vascular Ageing-MRI study. BMJ 2011;18-342.

[32] Calandre EP, Bembibre J, Arnedo ML, Becerra D. Cognitive disturbances and regional cerebral blood flow abnormalities in migraine patients:Their relationship with the clinical manifestations of the illness. Cephalalgia 2002;22:291-302.

[33] Schmitz N, Arkink EB, Mulder M, et al. Frontal lobe structure and executive function in migraine patients. Neurosci Lett 2008;440:92-96.

[34] Karner E, Delazer M, Benke T, Bösch S. Cognitive Functions, Emotional Behavior and quality of life in familial hemiplegic migraine. Cog Behav Neurol 2010;23:106-111.

[35] Martins IP, Cunha-Sá M. Loss of topographic memory and prosopagnosia during migraine aura. Cephalalgia 1999;19:841-843.

[36] Hadjikhani N, Sanchez Del Rio M, Wu O, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci U S A 2001;98:4687-4692.

[37] Schürks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. Migraine and cardiovascular disease:systematic review and meta-analysis. BMJ 2009;339:b3914.

[38] O'Bryant SE, Marcus DA, Rains JC, Penzien DB. The neuropsychology of reccurent headache. Headache 2006;46:1364-1376.

[39] Idiazábal MA, Palencia-Taboada AB, Sangorrin J, Espadaler-Gamissans JM. Potenciales evocados cognitivos em El transtorno por déficit de atención com hiperatividad. Rev Neurol (Barcelona) 2002;34:301-305.

[40] Shochat E, Scheuer CI, Andrade ER. ABR and auditory P300 findings in clhildren with ADHD. Arq Neuropsiquiatr 2002;60:742-747.

[41] Farias LS, Toniolo IF, Cóser PL. P300: avaliação eletrofisiológica da audição em crianças sem e com repetência escolar. Rev Bras Otorrinolaringolol 2004;70:194-199.

[42] Drake ME, Pakalnis A, Padamadan H. Long-latency auditory event related potentials in migraine. Headache 1989;29:239-241.

[43] Siniatchkin M, Kropp P, Gerber WD. What kind of habituation is impaired in migraine patients? Cephalalgia 2003;23:511-518.

[44] Merikangas KR, Risch NJ, Merikangas JR, Weissman MM, Kidd KK. Migraine and depression:association and familial transmission. J Psychiatric Res 1988;22:119-129.

[45] Merikangas KR, Merikangas JR, Angst J. Headache syndromes and psychiatric disorders:association and familial transmission. J Psychiatric Res 1993;27:197-210.

[46] Brandt J, Celentano D, Steward WF, Linet M, Folstein MF. Personality and emotional disorders in a community sample of migraine headache sufferers. Am J Psychiatry 1990;147:303-308.

[47] Breslau N, Davis GC, Andreski P. Migraine, psychiatric disorders, and suicide attempts:an epidemiologic study of young adults. Psychiatry Res 1991;37:11-23

[48] Breslau N, Andreaski P. Migraine, personality, and psychiatric comorbidity. Headache 1995;35:382-386.

[49] Rasmussen BK. Migraine and tension-type headache in a general population:psychosocial factors. Int J Epidemiol 1992;21:1138-1143.

[50] Merikangas KR. Psychopathology and headache syndromes in the community. Headache 1994;34:S17-S22.

[51] Peres MF, Mercante JP, Tanuri FC, Nunes M, Zukerman E. Chronic migraine prevention with topiramate. J Head Pain 2006;7:185-187.

[52] Suhr JA, Seng EK. Neuropsychological functioning in migraine: clinical and research implications. Cephalalgia . 2012;32:39-54.

[53] Láinez MJ, Freitaq FG, Pfeil J, Ascher S, Olson WH, Schwalen S. Time course of adverse events most commonly associated with topiramate for migraine prevention. Eur J Neurol. 2007;14:900-906.

[54] Romigi A, Cervellino A, Marciani MG, et al. Cognitive and psychiatric effects of topiramate monotherapy in migraine treatment:an open study. Eur J Neurol 2008;15:190-195.

[55] Krymchantowski AC, Jevoux CC. Condutas práticas em cefaléia e dores craniofaciais. São Paulo, Lippincott Williams & Wilkins; 2006:238.

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