Duration and frequency of migraines affect cognitive function: evidence from neuropsychological tests and event-related potentials

DOI: https://doi.org/10.1186/s10194- 017- 0758- 6

Abstract-Summary The aim of this study was to evaluate the changes in the cognitive performance of migraine patients using a comprehensive series of cognitive/behavioral and electro- physiological tests.

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Migraineurs performed worse in the majority of the Montreal Cognitive Assessment (MoCA) (p = 0.007) compared to the healthy subjects, significantly in language (p = 0.005), memory (p = 0.006), executive functions (p = 0.042), calcula- tion (p = 0.018) and orientation (p = 0.012).

We analyzed significant correlations between MoCA score and the duration of

migraine.

We also observed that a decrease in the MoCA-executive functions and calcula- tion score and in the ROCF-recall score were both correlated to the frequency of migraine.

Migraineurs were more anxious than healthy subjects (p = 0.001), which is inde-

pendent of cognitive testing.

Cognitive performance decreases during migraine, and cognitive dysfunction

can be related to the duration and frequency of a migraine attack.

Extended: Cognitive performance decreases during migraine, especially in lan- guage, memory, executive functions, calculation and orientation, and cognitive dys- functions can be related to the duration and the frequency of headache.

Background Migraine has been linked to an increased prevalence of clinically silent brain lesions and subtle gray matter damage which affect the cognitive processes [324, 325].

These associations suggest that individuals with migraines have impaired cogni-

tive function due to these structural lesions.

Previous studies of migraine and cognition have been contradictory. Some studies suggest that migraineurs have subtle interictal cognitive abnor-

malities aligning with attentional deficits [326–328].

Some studies have not found any significant differences in cognitive perfor-

mance between migraine patients and controls [329].

Given the high prevalence of migraine in the general population, it is clear that the relationship between cognitive dysfunction and migraines present a significant public health interest.

We hypothesized that migraine patients have cognitive dysfunction and P3 abnormalities, such as reduced P3 amplitude and/or a prolonged latency, suggesting alterations in the cognitive-evaluative component.

Methods Participants were instructed to press the button as quickly and accurately as possible when they viewed the target stimuli.

Reaction time was defined as the length between viewing the target stimuli and

pressing the button accurately.

The EEG segments were averaged separately for target and standard stimuli. The number of averaged trials left after removal of the artifacts was 40 (target)

and 160 (standard).

The difference waveform was obtained by subtracting ERPs in response to stan-

dard stimuli from those in response to target stimuli.

The peak amplitudes and latencies for the P3 component were measured relative

to the pre-stimulus baseline period.

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2 Mechanisms

Student’s t-test for independent samples (two-tailed) was used to compare the

two groups in the scores of cognitive test, p3 amplitude and latency.

Correlations between clinical (illness duration and frequency of attacks), cogni- tive test (MoCA, ROCF, DSST) and electrophysiological (ERP components ampli- tude and latency) data were computed.

Results Significant differences were observed in the MoCA (p = 0.007), especially in lan- guage, memory, executive functions, calculation and orientation.

There was no significant group difference in accuracy (migraineurs, 97.41%; healthy subjects, 98.38%; p = 0.187), or in the appropriate reaction time between migraineurs (449.1 ms) and healthy subjects (445.1 ms; p = 0.272).

In the migraine group, the P3 amplitude varied between sites, was maximal in the parietal lobe (Pz: 9.906 μV) and minimal in the frontal lobe (Fz: 8.243 μV), with intermediate values at Cz (8.735 μV), but the difference did not reach statistical significance (p = 0.319).

We observed that the MoCA score showed a significant, negative and moderate correlation with the duration of migraine, especially in the aspects of language, executive functions, calculation and memory.

Discussion The present study revealed that migraine patients had significantly lower scores than controls on cognitive tests and increased P3 latencies.

The present study revealed that migraineurs had significantly lower scores than healthy subjects on the delayed recall of ROCF test, the total MoCA and in five out of seven cognitive subdomains (i.e., language, executive functions, calculation, memory and orientation domains).

This indicates that the reduced scores on cognitive tests observed in migraineurs compared with controls is directly related to the length of time and the frequency of patient’s suffering from migraine.

Riva D assessed the effect of migraine on the interictal functioning of children and adolescents and observed that both patient groups had cognitive performance within a normal range, except for a significant delay in the reaction time task.

Some studies have shown that the amplitudes of P3 were significantly decreased in migraine patients compared with the healthy subjects, but the latencies of P3 did not show any significant effects [330, 331].

Conclusions Cognitive performance decreases during migraine, especially in language, memory, executive functions, calculation and orientation, and cognitive dysfunctions can be related to the duration and the frequency of headache.

Acknowledgement A machine generated summary based on the work of Huang, Lifang; juan Dong, Hong; Wang, Xi; Wang, Yan; Xiao, Zheman. 2017  in The Journal of Headache and Pain.

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Olfactory bulbus volume and olfactory sulcus depth in migraine patients: an MRI evaluation