Cognitive Performance, Mood Deficits, White Matter Hyperintensities in Migraine

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There was no correlation with MocA scores in patients with migraines and the presence and number of white matter hyperintensities.
There was no correlation with MocA scores in patients with migraines and the presence and number of white matter hyperintensities.

Patients suffering from migraine with aura (MwA) have a higher level of cognitive impairment compared with those without aura (MwoA) and healthy control patients, according to a prospective, case-control study published in the Polish Journal of Neurology and Neurosurgery.

The study also showed that patients with migraines were more likely to have white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI), which reflect differences in white and gray matter brain regions. Although psychological assessments for depression and anxiety were correlated with cognitive impairment in patients suffering from migraine, no correlation between cognitive impairment and WMH was noted.

Investigators recruited study participants from a neurology clinic, including 100 adult patients suffering from migraine and 80 healthy control patients. Migraine was diagnosed using the International Classification of Headache Disorders, 3rd edition.

Montreal Cognitive Assessment (MoCA) scores were used to measure cognitive function. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used as part of a psychological evaluation. Whole-brain magnetic resonance imaging was collected from each participant for WMH assessment.

Forty-seven patients were categorized as MwA and 53 patients as MwoA. Performance on MoCA was significantly lower in patients with MwA vs patients with MwoA and healthy control patients (P =.014 and P =.030, respectively). Comparison between patients with MwA and patients with MwoA revealed significant decreases in performance in the following domains: attention, abstraction, visuospatial/executive functioning, memory, and naming (P =.001, P =.001, P =.003, P =.028, and P =.044, respectively).

A significantly higher number of patients with migraine evidenced with WMHs compared with healthy control patients (P =.044); however, no significant correlation was evidenced between the presence of WMHs and MoCA scores.

BAI and BDI indices were significantly correlated with MoCA scores in patients with migraine (P =.013 and P =.042, respectively).

"This study suggested that the effects of migraine are not limited to headaches," the authors wrote. Although the study was limited by its sample size and cross-section design, "these results...highlighted the importance of carefully assessing the cognitive performance using a screening tool that is as sensitive as the MoCA test in detecting visuospatial/executive, attention, and memory dysfunction."

Reference

Tunc A, Tekesin AK, Gungen BD, Arda E. Cognitive performance in young and middle-aged adults with migraine: Investigating the correlation with white matter hyperintensities and psychological symptoms [published online May 8, 2018]. Neurol Neurochir Pol. doi: 10.1016/j.pjnns.2018.05.001

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