Children with migraine without aura (MWoA) do not have problems with metacognition and Theory of Mind (TOM) compared with healthy counterparts, according to study results published in Frontiers in Neurology.

In this study, researchers evaluated 140 children between the ages of 8 and 13 to investigate the relationship between migraine and metacognition, TOM, and alexithymia. Participants were divided into 2 groups of 70. The experimental group consisted of boys (n=36) and girls (n=34) diagnosed with MWoA. The control group consisted of healthy boys (n=31) and girls (n=39).

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All participants completed the Alexithymia Questionnaire for Children to assess alexithymia and the Domain of Social Perception in the NEPSY-II to assess TOM. Metacognition was measured using the questionnaire “Io e la mia mente” for children 8 to 10 and the Metacognitions Questionnaire for Children for children 11 to 13. Researchers then compared results between the experimental and control groups, boys and girls regardless of age and group, and results between children ages 8 to 10 and preadolescents ages 11 to 13.

Results revealed that the Alexithymia Questionnaire for Children scores were significantly different between the experimental and control groups in the subscales “Difficulty Describing Feelings” (=.04) and “Difficulty Identifying Feelings” (=.01). Children with MWoA scored higher in these subscales (interquartile range [IQR] 4-7 and 5-9, respectively) than controls (IQR 2-6 and 3.2-8, respectively). Younger children aged 8 to 10 obtained higher scores in the total score (IQR, 16-23) and in the “Difficulty Identifying Feelings” (IQR 5-9) subscale than older children aged 11 to 13 (IQR 13-21 and IQR 3-8, respectively).

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In regards to TOM and metacognition, results from the Domain of Social Perception of NEPSY-II and the 2 questionnaires showed no significant differences between experimental or control groups; boys or girls; and younger children or preadolescents. The only significant difference was in the “Negative Meta Worrying” subscale of the Metacognitions Questionnaire for Children, in which girls had higher scores than boys (=.01) regardless of the group they were in.

This study had a few limitations. First, the number of study participants was relatively low. Second, the study included only patients who voluntarily attended a specialist center. Third, tests were self-administered, so results have to take social desirability into account.

The study researchers concluded there are no differences in TOM and metacognition between children with MWoA and healthy children and suggest that the study findings merit further investigation.

Natalucci G, Faedda N, Quinzi A, et al. Alexithymia, metacognition, and Theory of Mind in children and preadolescents with migraine without aura (MWoA): a case-control study [published online July 17, 2019]. Front Neurol. doi: 10.3389/fneur.2019.00774