Cognitive performance in patients with chronic tension-type headache and its relation to neuroendocrine hormones

Abstract

Background: Tension-type headache is the most common headache to be seen in clinical practice. Depression is highly prevalent in chronic tension-type headache (CTTH) patients attending the clinical settings. Cognitive impairment and neuroendocrine dysregulation had been reported in patients with depression and patients with CTTH. Objective: To assess the cognitive performance and investigate its possible relations to neuroendocrine levels in patients with CTTH. Subjects and methods: Patients with CTTH, depression, and control subjects were recruited. CTTH was diagnosed according to the International Classification of Headache Disorders. Cognitive performance, depression severity, and pain intensity were assessed by the Montreal Cognitive Assessment Arabic version, Beck's Depression Inventory, and McGill Pain Questionnaire respectively. Blood samples were collected in the morning within 60 min after waking up from 8:00 to 9:00 a.m. to measure serum levels of basal plasma CRH, ACTH, Cortisol, TSH, FT3, and FT4. Results: Both patients with CTTH and depression had impaired cognitive performance. Patients with CTTH and patients with depression had altered the hypothalamus-pituitary-adrenal axis, and pituitary-thyroid axis. The hormonal levels significantly correlated with cognitive function in patient groups, especially patients with CTTH. Conclusion: Patients with CTTH had cognitive dysfunction which could be related to neuroendocrine hormonal dysregulation.

Evidence for Cognitive Decline in Chronic Pain: A Systematic Review and Meta-Analysis

“…From the 15,316 records identified by the search methods, 37 studies (Demirci and Savas, 2002 ; Weiner et al, 2006 ; Meeks et al, 2008 ; Shega et al, 2010 , 2012 ; Jonsson et al, 2011 ; Walteros et al, 2011 ; Ko et al, 2013 ; Pirrotta et al, 2013 ; Butterworth et al, 2014 ; Docking et al, 2014 ; Hagen et al, 2014 ; Martinsen et al, 2014 ; Pickering et al, 2014 ; Coppieters et al, 2015 ; Meeus et al, 2015 ; Öncü et al, 2015 ; Dos Santos Ferreira et al, 2016 ; Fernández-Lao et al, 2016 ; Santangelo et al, 2016 ; Schepker et al, 2016 ; Kaiho et al, 2017 ; Tzeng et al, 2017 ; Whitlock et al, 2017 ; Jordan et al, 2018 ; Ojeda et al, 2018 ; Pidal-Miranda et al, 2018 ; Qu et al, 2018 ; Van Der Leeuw et al, 2018b , 2020 ; Veronese et al, 2018 ; Gu et al, 2019 ; Ikram et al, 2019 ; Samartin-Veiga et al, 2019 ; Kotb et al, 2020 ; Latysheva et al, 2020 ; Nakai et al, 2020 ) were identified, a total of 52,373 patients with CP and 80,434 healthy control participants. These 37 studies included different types of CP: headache ( n = 7); fibromyalgia syndrome (FM) ( n = 6); low back pain ( n = 3); whiplash-associated disorder ( n = 2); foot pain ( n = 2); cancer pain ( n = 1); low back pain and knee pain ( n = 1); neuropathic pain ( n = 1); musculoskeletal pain, neuropathic pain, and FM ( n = 1); post-herpetic neuralgia ( n = 1); non-cancer pain ( n = 1); and other unclassified CP ( n = 13).…”