Abstract
Neuroimaging and neuropsychological investigations have indicated that migraineurs exhibit frontal lobe-related cognitive impairment. We investigated whether orbitofrontal and dorsolateral functioning differed between individuals with episodic migraine (EM) and chronic migraine (CM), focusing on orbitofrontal dysfunction because it is implicated in migraine chronification and medication overuse headache (MOH) in migraineurs. This cross-sectional study recruited women with CM with/without MOH (CM + MOH, CM − MOH), EM, and control participants who were matched in terms of age and education. We conducted neuropsychological assessments of frontal lobe function via the Trail Making Test (TMT) A and B, the Wisconsin Card Sorting Test (WCST), and the Iowa Gambling Task (IGT). We enrolled 36 CM (19 CM + MOH, 17 CM − MOH), 30 EM, and 30 control participants. The CM patients performed significantly (p < 0.01) worse on the TMT A and B than the EM patients and the control participants. The WCST also revealed significant differences, with poorer performance in the CM patients versus the EM patients and the control participants. However, the net scores on the IGT did not significantly differ among the three groups. Our findings suggest that the CM patients exhibited frontal lobe dysfunction, and, particularly, dorsolateral dysfunction. However, we found no differences in frontal lobe function according to the presence or absence of MOH.
Highlights
A consensus has not yet been established regarding frontal-related cognitive performance in these patients. To address this in the present study, we investigated whether individuals with episodic migraine (EM) and chronic migraine (CM) differed in terms of frontal lobe-related cognitive function during the interictal period
36 patients with CM (19 CM + medication overuse headache (MOH), 17 CM − MOH), 30 patients with EM, and 30 control participants were enrolled in the study
There were no significant differences in Headache Impact Test-6 (HIT-6) and Generalized Anxiety Disorder7 (GAD-7) scores between the patients with EM and CM
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Cognitive symptoms are not considered among the core symptoms of migraines, many migraineurs often complain of cognitive dysfunction. Cognitive symptoms rank second after pain in terms of intensity and attack-related disability [1]. A clinical series on migraines reported that cognitive symptoms occurred in all phases of a migraine attack [2]. Clinical studies consistently report poor cognitive performance during migraine attacks, the data regarding cognition in the interictal period are conflicting. During the interictal period, most clinic-based studies have indicated that migraineurs show impaired cognitive function, whereas population-based studies have revealed no differences in cognitive function between migraineurs and controls [3]
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