Cognitive impairment in migraine:A systematic review

Araújo, Caroline Martins de; Barbosa, Izabela Guimarães; Lemos, Stela Maris Aguiar; Domingues, Renan Barros; Teixeira, Antônio Lúcio

doi:10.1590/s1980-57642012dn06020002

Cited by 56 publications

(60 citation statements)

References 53 publications

(82 reference statements)

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“…Interictal symptoms observed in migraineurs, including persistent hypersensitivity to light, sound, and smell, as well as visual snow, and cognitive slowing, were also observed in our patients. Psychiatric disorders were frequently encountered, particularly anxiety, underscoring the relationship between vestibular disturbances with mood disorders …”

Section: Discussionsupporting

confidence: 74%

The Spectrum of Vestibular Migraine: Clinical Features, Triggers, and Examination Findings

et al. 2019

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Objective To assess the ictal symptoms, interictal symptoms, psychiatric comorbidities, and interictal neuro‐otologic examination findings in vestibular migraine (VM). Methods Retrospective chart review of 491 patients seen from August 2014 until March 2018 at a tertiary neurology referral center for vestibular disorders to identify patients fulfilling the 2012 VM criteria. Results One hundred and thirty‐one patients (105 women) were identified. Mean age of VM onset was 44.3 (±13.7) years. Preceding the onset of vestibular symptoms, most had migraine (57.3%) and motion sickness (61.1%). It was common to have a family history of migraine (50.8%) and episodic vestibular symptoms (28.1%). Common ictal symptoms were triggered (visually induced and head‐motion) and spontaneous vertigo, accompanied by photophobia and phonophobia (118/131 [90.1%] patients), nausea (105/131 [80.2%] patients), aural symptoms (79/131 [60.3%] patients), and headache (65/131 [49.6%] patients). Interictally, many experienced visually induced (116/131 [88.6%] patients), head‐motion (86/131 [65.6%] patients), and persistent (67/131 [51.1%] patients) dizziness. Psychiatric comorbidities include anxiety (92/131 [70.2%] patients), depression (53/131 [40.5%] patients), insomnia (38/131 [29.0%] patients), phobic disorders (15/131 [11.5%] patients), and psychogenic disorders (11/131 [8.4%] patients). Common triggers were stress (52/131 [39.7%] patients), bright lights (35/131 [26.7%] patients), weather changes (34/131 [26.0%] patients), and sleep deprivation (34/131 [26.0%] patients). Interictal neuro‐otologic examination was abnormal in 56/131 (42.7%), usually hyperventilation‐induced, head‐shaking‐induced, vibration‐induced, and positional nystagmus. The most common balance‐test finding was impaired sharpened Romberg’s test (22/130 [16.9%] patients). Conclusions In this single center study, we found that VM typically affects women in their 40s, with a personal and family history of migraine. Typical ictal symptoms were triggered and spontaneous vertigo, associated with photophobia and phonophobia, nausea, aural symptoms, and headache. Interictal vestibular symptoms, comorbid psychiatric disorders, and non‐specific interictal neuro‐otologic findings were common.

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Section: Discussionsupporting

confidence: 74%

The Spectrum of Vestibular Migraine: Clinical Features, Triggers, and Examination Findings

et al. 2019

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“…The MSHA migraine measure did not distinguish between migraines with and without aura. Although there are some reports of more severe cognitive consequences in migraines with aura, the effect of aura on the association between migraine and cognitive impairment appears to be inconsistent . This study found a significant association between migraines and AD despite the inclusion of migraine without aura in the general migraine measure.…”

Section: Discussioncontrasting

confidence: 57%

“…Nevertheless, significant associations of migraines with AD and all‐cause dementia were noted in our study, even with a single, simple migraine measure. Additional data on migraine characteristics, such as use of migraine medications, frequency of migraine attacks, and severity or intensity of migraine attacks, would aid in determining the effects of migraines on cognitive outcomes . Differences across migraineurs in factors unrelated to migraine (eg, comorbidities) may also help to explain inconsistent associations between migraines and cognition .…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive consequences of migraines have been more thoroughly studied for cognition in general than for cognitive states such as dementia. Although one systematic review concluded that migraines were associated with mild cognitive changes across several domains, particularly in patient populations, other reviews focusing on stronger cohort study designs have concluded that current evidence does not support an association between migraines and cognitive decline. However, evidence is less clear on the impact of migraines on dementia.…”

Section: Introductionmentioning

confidence: 99%

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Migraine and the risk of all‐cause dementia, Alzheimer's disease, and vascular dementia: A prospective cohort study in community‐dwelling older adults

Morton

John

Tyas

2019

Int J Geriat Psychiatry

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Objectives Dementia is the most common neurological disease in older adults; headaches, including migraines, are the most common neurological disorder across all ages. The objective of this study was to explore the relationship between migraines and dementia, including Alzheimer's disease (AD) and vascular dementia (VaD). Methods Analyses were based on 679 community‐dwelling participants 65+ years from the Manitoba Study of Health and Aging, a population‐based, prospective cohort study. Participants screened as cognitively intact at baseline had complete data on migraine history and all covariates at baseline and were assessed for cognitive outcomes (all‐cause dementia, AD, and VaD) 5 years later. The association of exposure (lifetime history of migraines), confounding (age, gender, education, and depression), and intervening variables (hypertension, myocardial infarction, other heart conditions, stroke, and diabetes) with all‐cause dementia and dementia subtypes (AD and VaD) was assessed using multiple logistic regression models. Results A history of migraines was significantly associated with both all‐cause dementia (odds ratio [OR]=2.97; 95% confidence interval [CI]=1.25‐6.61) and AD (OR=4.22; 95% CI=1.59‐10.42), even after adjustment for confounding and intervening variables. Migraines were not significantly associated with VaD either before (OR=1.83; 95% CI=0.39‐8.52) or after (OR=1.52; 95% CI=0.20‐7.23) such adjustment. Conclusions Migraines were a significant risk factor for AD and all‐cause dementia. Despite the vascular mechanisms involved in migraine physiology, migraines were not significantly associated with VaD in this study. Recognition of the long‐term detrimental consequences of migraines for AD and dementia has implications for migraine management, as well as for our understanding of AD etiology.

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“…Patients with migraine with aura exhibit more prominent cognitive changes than do patients with migraine without aura. Aura is likely associated with cortical functioning interference (cortical spreading depression) and decreased brain perfusion .…”

Section: Discussionmentioning

confidence: 99%

Subjective cognitive complaints and migraine characteristics: A cross‐sectional study

et al. 2020

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Objectives Subjective cognitive complaints by patients with migraine have been associated with memory impairment. However, whether the severity of memory impairment relates to migraine characteristics, such as attack frequency and aura, remains undetermined. We investigated the relationship between subjective cognitive complaints and migraine characteristics. Materials and methods This cross‐sectional study recruited 669 clinic outpatients from Taiwan. We stratified them by migraine frequency and the presence or absence of aura, and we controlled the data for confounding variables. We performed multivariable linear and logistic regressions to investigate whether different migraine frequencies are associated with subjective cognitive complaints, which were evaluated by the subjective memory complaints scale and the Ascertain Dementia 8 (AD8) questionnaire. Results Total subjective memory complaints scores tended to increase with the migraine attack frequency (P = .022) in patients with migraine with aura; similar results were obtained for AD8 scores in women with migraine with aura. Poor sleep quality was associated with a higher total subjective memory complaint (B = 0.08, 95% confidence interval [CI] = 0.03‐0.14) and AD8 (B = 0.07, 95% CI = 0.02‐0.11) scores. In addition, more severe depression was associated with higher total subjective memory complaints and AD8 scores (B = 0.05, 95% CI = 0.02‐0.09; B = 0.08, 95% CI = 0.05‐0.11, respectively). Conclusions Subjective cognitive complaints tend to increase with the frequency of migraines with aura, and this interrelation is substantially influenced by depression severity and sleep disturbances.

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Cognitive impairment in migraine:A systematic review

Cited by 56 publications

References 53 publications

The Spectrum of Vestibular Migraine: Clinical Features, Triggers, and Examination Findings

The Spectrum of Vestibular Migraine: Clinical Features, Triggers, and Examination Findings

Migraine and the risk of all‐cause dementia, Alzheimer's disease, and vascular dementia: A prospective cohort study in community‐dwelling older adults

Subjective cognitive complaints and migraine characteristics: A cross‐sectional study

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