Compared with people without migraine, people with migraine and migraine with medication overuse headache often have deficits in metacognition, or the ability to monitor one’s own cognitive functioning and direct one’s behavior. This is according to a study published in the Journal of Clinical Neuroscience.
A total of 64 patients with migraine (mean age, 45.65±11.61 years) were recruited from a center in Italy that specializes in treating headache. Patients had episodic migraine without aura (n=27) or chronic migraine and medication-overuse headache (n=37). In addition, a total of 29 control patients (mean age ± SD, 42.86±14.78 years) were also selected for enrollment. The researchers assessed metacognitive and executive skills for each participant with the metacognitive version of the Wisconsin Card Sorting Test.
Compared with controls, patients with migraine had lower performance during metacognitive tasks, which were shown through worse outcomes in accuracy score (P =.012), global monitoring (P =.015), monetary gains (P =.022), and control sensitivity (P =.027). Significantly lower scores were observed in most metacognitive indices of the Wisconsin Card Sorting Test among patients with chronic migraine with medication overuse headache vs patients with episodic migraine in terms of the accuracy score (P <.001), free-choice improvement (P =.004), global monitoring (P =.001), monetary gains (P =.001), and control sensitivity (P <.001).
Limitations of the study included the small number of participants as well as variation with regard to patients taking or not taking preventive medications.
The researchers suggest that “metacognitive deficits may become a possible new therapeutic target in” patients with migraine as well as in patients with chronic migraine with medication overuse headache.
Zucca M, Rubino E, Vacca A, et al. Metacognitive impairment in patients with episodic and chronic migraine. J Clin Neurosci. 2020;72:119-123.