Migraine: A Possible Cause for Cognitive Decline

Abstract

Objectives: Migraine is the second most common type of headache and seventh most disabling disease worldwide. In general, obesity is often related to headache disorders in several clinical and epidemiologic studies. Obese migraine patients may have an increased attack frequency due to the increase in inflammatory response. Cognitive decline is present in several migraine patients. However, some researchers differ. Body mass index (BMI) is also seen to have a role in migraine. This study has been done (i) to define whether cognitive decline is present in a significant degree in migraine patients and also (ii) to test whether an association exists between migraine and BMI. Methods:The study protocol was approved by the ethical committee of SRM Medical College Hospital and Research Centre. The study group consisted of 30 migraine patients and 30 healthy controls aged between 18 and 40 years of age. Informed consent was obtained from all the participants. The diagnosis of migraine was made using the criteria of the 2 nd edition of International Headache Classification. Patients affected by diabetes mellitus, hypertension, allergy, inflammation, infection, or immune disorders were excluded from the study to avoid confounding etiology. Height and weight of the subjects were taken to calculate the BMI. Cognitive tests such as Stroop interference trial and trial-making tests (A and B) were done to evaluate working memory, mental flexibility, and attention.Results: Compared to controls, cases took more time for performing Stroop color card test (106.40±15.87 seconds vs. 132.17±7.027 seconds, p<0.001) and trial-making pattern B (54.77±8.169 seconds vs. 56.23±23.457 seconds, p=0.004). Among the migraine subjects, obese individuals had an increased frequency of migraine attack per month (correlation coefficient r=0.797). Conclusion:In this study, we have found a linear increase in the frequency of migraine in persons with higher BMI. Moreover, migraine subjects had a decline in cognitive function in our study, and it is found to be statistically significant. Identifying cognitive decline early can prevent major consequences in day-to-day activities of migraine patients. Since there is an increased frequency of migraine with increase in BMI, obese migraine subjects can be recommended to do regular exercises.

In search of a neuropsychological profile for migraine: A scoping review

“…Poormina et al. (2017) also found that mean time needed to complete the Stroop test was significantly higher for migraineurs ( M = 132.17, SD = 7.027 s) compared to controls ( M = 106.40, SD = 15.87 s, p < 0.001), thus suggesting inter‐ictal attention and processing speed impairments in the migraine population. This attentional deficit may further worsen as a migraine cycle progresses.…”

“…With regards to attention, studies show quite a consistent pattern of attention and information processing speed deficits in migraineurs (Agessi et al., 2014; Ferreira et al., 2018; Gil‐Gouveia et al., 2015b; Martins et al., 2012; Mickleborough et al., 2013; Poormina et al., 2017), with some reporting a specific poorer performance in female patients (Guo et al., 2019). Yannick et al.…”

“…Poormina et al. (2017) found a statistically significant difference in time needed to complete the TMT‐B for migraineurs ( M = 54.77, SD = 8.169 s) compared to healthy controls ( M = 56.23, SD = 23.457 s; p < 0.001). Similarly, Pellegrino Baena et al.…”

“…With regards to attention, studies show quite a consistent pattern of attention and information processing speed deficits in migraineurs (Agessi et al, 2014;Ferreira et al, 2018;Gil-Gouveia et al, 2015b;Martins et al, 2012;Mickleborough et al, 2013;Poormina et al, 2017), with some reporting a specific poorer performance in female patients (Guo et al, 2019). Yannick et al (2015) remark a reduction of selective attention during the inter-ictal period and Chen et al ( 2021) found worse attentional control in migraineurs without aura when compared to health controls.…”

“…For the domain of executive functions, a general pattern of impaired functions was found across several studies (Huang et al., 2017; Ribeiro et al., 2017; Santangelo et al., 2016; Tunç et al., 2018). In more specific terms, deficits have been reported in migraineurs in terms of slower set shifting and cognitive flexibility (Han et al., 2019; Lo Buono et al., 2019; Pellegrino Baena et al., 2018; Poormina et al., 2017; Schmitz et al., 2008; Yannick et al., 2015), impaired decision‐making (Biagianti et al., 2012; Viticchi et al., 2017), worse performance in working memory tasks (Ferreira et al., 2018; Santos‐Lasaosa et al., 2013) and impaired prospective memory (Santangelo et al., 2018). Against this trend, five studies reported non‐significant differences between migraineurs and controls (Kim et al., 2020; Koppen et al., 2011; Martins et al., 2020; Quadros et al., 2020; Schmitz et al., 2008), despite some of them showing some trend of a worse performance in pre‐ictal stages that requires further research and only one study (Baschi et al., 2019) reported better significant results for migraineurs.…”