Abstract
There are few literature evidences about the intellectual profile of adolescents with headache and no study has used the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in patients with a diagnosis of headache according to the ICHD-III-beta. We recruited 30 patients (age 11–14 years; male:female = 1:2) seen for headache in a tertiary center in Northern Italy and 30 healthy controls matched for age and sex, recruited in a public school from the same geographic area. The diagnosis of headache was done according to the ICHD-III criteria (beta version): the case group was composed of 16 patients with migraine and 14 with tension-type headache. Cognitive functioning was assessed using the WISC-IV. Recruited patients with idiopathic headache diagnosis had on average a cognitive function within the normal range. We found no statistically significant differences in the total Intellective Quotient comparing patients with headache and controls; the Working Memory Index was, however, lower in patients with headache (p = 0.012), and in particular, we found a lower Digit Span (p < 0.001). We also found a borderline statistical difference (p = 0.051) between case and controls Verbal Comprehension Index (CVI), which was due to a lower score in the Similarities subtest (p < 0.001). Our results suggest that, although within normal limits, cognitive functioning of adolescents with headache differs from that of healthy peers regarding memory and verbal skills. The Working Memory Index is related to the subject’s ability to store new information and keep them in short-term memory, to maintain focused attention and to manipulate them to find solutions. The difference in Similarities is also important because it provides a measure of the level of verbal reasoning and concept formation; it is also a measure of verbal abstract thinking skills relevant for language development, lexical knowledge, auditory comprehension, memory, and ability to discriminate between essential and non-essential characteristics. Our data, in keep with previous findings, suggest the need for further researches to better understand the pathogenesis of these difficulties and obtain ideas for an adequate rehabilitative treatment.
Highlights
Headache is a common disorder in children and adolescence; it has a negative effect on life quality, is a relevant cause of missed school days, and determines a significant health-related cost [1]
A more recent Brazilian study used the Wechsler Intelligence Scale for Children—III edition to confirm the normality of the Intelligence Quotient in both migraineurs and healthy control, which showed significantly lower scores in some subtests in children and adolescents with headache [14]
In order to try to explain these findings, the hypothesis of a decrease of some cognitive skills limited to the migraine attack was studied [15]
Summary
Headache is a common disorder in children and adolescence; it has a negative effect on life quality, is a relevant cause of missed school days, and determines a significant health-related cost [1]. As to tension-type headache, it is not clear if the difficulties reported in terms of academic failure are due to headache per se or to the loss of school days secondary to pain experienced [5]. This it is evident that the existing literature concerning cognitive aspects in children and adolescents is far from being conclusive. A number of potentially significant factors have not been evaluated in detail, including psychopathological aspects and the effect of medications taken both for relieving pain and as preventive
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