Intellectual Profile of Adolescents with Headache: A Case–Control Study Using the WISC-IV

Abstract

There are few literature evidences about the intellectual profile of adolescents with headache and no study has used the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in patients with a diagnosis of headache according to the ICHD-III-beta. We recruited 30 patients (age 11–14 years; male:female = 1:2) seen for headache in a tertiary center in Northern Italy and 30 healthy controls matched for age and sex, recruited in a public school from the same geographic area. The diagnosis of headache was done according to the ICHD-III criteria (beta version): the case group was composed of 16 patients with migraine and 14 with tension-type headache. Cognitive functioning was assessed using the WISC-IV. Recruited patients with idiopathic headache diagnosis had on average a cognitive function within the normal range. We found no statistically significant differences in the total Intellective Quotient comparing patients with headache and controls; the Working Memory Index was, however, lower in patients with headache (p = 0.012), and in particular, we found a lower Digit Span (p < 0.001). We also found a borderline statistical difference (p = 0.051) between case and controls Verbal Comprehension Index (CVI), which was due to a lower score in the Similarities subtest (p < 0.001). Our results suggest that, although within normal limits, cognitive functioning of adolescents with headache differs from that of healthy peers regarding memory and verbal skills. The Working Memory Index is related to the subject’s ability to store new information and keep them in short-term memory, to maintain focused attention and to manipulate them to find solutions. The difference in Similarities is also important because it provides a measure of the level of verbal reasoning and concept formation; it is also a measure of verbal abstract thinking skills relevant for language development, lexical knowledge, auditory comprehension, memory, and ability to discriminate between essential and non-essential characteristics. Our data, in keep with previous findings, suggest the need for further researches to better understand the pathogenesis of these difficulties and obtain ideas for an adequate rehabilitative treatment.

Interictal Cognitive Performance in Children and Adolescents With Primary Headache: A Narrative Review

“…The absence of association between the intelligence profile and migraine features in children and adolescents was also confirmed in a more recent study ( 45 ). The authors described the risk of lower verbal performance in young patients with headache diagnosis (20 children with migraine and 10 with TTH, age ranging from 11 to 14 years) in comparison with healthy children.…”

“…As discussed by the authors, since these functions are associated with the ability to use schemas to seek information and organize thoughts, their impairment may lead to poor school performance. The results of a study by Chiappedi et al ( 45 ) provided confirmatory evidence that adolescents affected by headache (migraine and TTH) may have short-term memory difficulties. Although a specific structured evaluation of memory was not performed, cognitive test WISC-IV showed specific impairment in the “Working Memory” index, especially concerning the subtest “Digit Span,” which provides a measure of the ability to store, manage and manipulate information indispensable for language and learning.…”

“…Data on the role of migraine features on memory abilities in pediatric patients are sparse ( Table 1 ). To the best of our knowledge, in addition to the above mentioned studies ( 39 , 45 ), only Calandre et al ( 32 ) explored this topic. In a sample of 28 adults and 32 pediatric patients with migraine, the authors described an impairment of short- and long-term visual memory, verbal memory, and working memory, related to frequency of the attacks and headache history.…”

“…An increasing body of research explored the role of pediatric migraine severity on cognitive resources in the headache free period ( 32 , 38 – 40 , 45 , 46 , 82 ). There is evidence that early age of onset and high frequency of the attacks may represent factors favoring cognitive impairment ( 32 , 40 ).…”

Measurement Invariance of the WHODAS 2.0 Across Youth With and Without Physical or Mental Conditions

“…Items related to cognition, particularly the ability to concentrate on a task for a given amount of time, may overlap with symptoms of physical or mental conditions. For example, youth with epilepsy or migraine headache have cognitive deficits related to the storage of new information, maintaining focus, and the ability to generate solutions to solve problems (Chiappedi et al, 2018; Costa-Silva, Prado, de Souza, Gomez, & Teixeira, 2016; Hermann et al, 2008; Holmes, 2016; Rathouz et al, 2014). In a related vein, difficulty with concentration is a core feature of depressive and anxiety disorders, as well as being a defining symptom of attention-deficit hyperactivity disorder (American Psychiatric Association, 2013)—the most common mental conditions affecting youth (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015).…”