Headache - A Window to Dementia: An Unexpected Twist

Abstract

Migraine and other types of headaches have several symptoms associated with them. The association between migraine and dementia has been considered. It is a topic of discussion and appears to be multifactorial. Dementia is a cluster of symptoms, with memory loss and cognitive dysfunction being the prominent symptoms. In this review, we discussed the association of headache and cognitive dysfunction in a broader context and how the practiced treatment of headaches may silently lead to dementia. We conducted a thorough literature search using PubMed as our main database. The articles exploring the association between headache (both migraine and non-migraine) and dementia were included. Some risk factors like migraine-induced stroke and inherent vascular diseases in migraine patients channeling to stroke and dementia were not considered. A total of 28 studies were included for review. All the reviewed studies put together showed an association between headache and cognitive dysfunction of any form. They showed that the frequency and duration of headache is a determinant for dementia. Few studies also focused on how treating headaches with certain drugs can lead to dementia. The reviewed published literature showed that headaches of any sort and their treatment are potentially linked to dementia. Not all headache patients will require medical treatment, as the benefit might outweigh the risk sometimes. It is interim to understand these facts and formulate a better protocol for treating headache patients. However, due to some discordant results, further studies are needed.

Different Aspects of Aging in Migraine

“…Many more recent studies suggest a positive association between migraine and impairment in cognitive functions/dementia (reviewed in [ 137 ]). Not only all-cause dementia but also AD, were observed at a greater ratio in 65+ years old migraineurs than age-matched controls [ 144 ].…”

“…It is still an open question whether migraine may modulate such changes in cognitive functions or/and vice versawhether impairment in cognitive functions may contribute to migraine pathogenesis. It seems especially important in the context of the association between migraine, all-causes dementia and AD [135][136][137].…”

Migraine is a Multifaceted Condition That is More Than Just a Headache: A Review

“…The most widely used and validated recipe notably, a "literature survey" was first used to search for "migraine's comorbidity", which revealed that migraine is comorbid with various common and detrimental conditions which include temporomandibular disorders (TMD) [65], mood and anxiety disorders [66,67], restless legs syndrome (RLS) [68], alexithymia and post-traumatic stress disorder [69], depression [70], ischemic strokes [71], hypertension [72], asthma [73], dementia [74,75], cardiovascular disorders [76], sleep disorders [77], PFO (Patent Foramen Ovule) [78], gastroesophageal reflux, tooth wear, systemic inflammation of Behçet's disease (BD) [79], irritable bowel syndrome [153], Chronic Fatigue Syndrome (CFS) where that mechanisms of migraine pathogenesis such as central sensitization may contribute to CFS pathophysiology [80]. It has been also shown that sleep fragmentation and oxygen desaturation may worsen migraine but migraine may help in reducing apneas by a more superficial sleep [152].…”