Neuropsychological and Neuropsychiatric Features of Chronic Migraine Patients during the Interictal Phase

Abstract

This study aimed to examine the presence of neuropsychological deficits and their relationships with clinical, pharmacological, and neuropsychiatric characteristics in chronic migraine (CM) patients assessed during a headache-free period. We enrolled 39 CM patients (mean age: 45.4 years; male/female ratio: 3/36) and 20 age-, sex-, and education-matched healthy controls (HCs, mean age: 45.5 years; male/female ratio: 2/18) in a case–control study. All CM patients underwent a full and extensive clinical, neuropsychiatric, and neuropsychological evaluation to evaluate cognitive domains, including sustained attention (SA), information processing speed (IPS), visuospatial episodic memory, working memory (WM), and verbal fluency (VF), as well as depressive and anxiety symptoms. CM patients exhibited higher scores than HCs for all clinical and neuropsychiatric measures, but no differences were found in personality characteristics. Although more than half of the CM patients (54%) showed mild-to-severe neuropsychological impairment (NI), with the most frequent impairments occurring in short- and long-term verbal episodic memory and inhibitory control (in approximately 90% of these patients), almost half of the patients (46%) showed no NI. Moreover, the severity of NI was positively associated with the number of pharmacological treatments received. Remarkably, disease-related symptom severity and headache-related disability explained global neuropsychological performance in CM patients. The presence of cognitive and neuropsychiatric dysfunction during the interictal phase occurred in more than half of CM patients, increasing migraine-related disability and possibly exerting a negative impact on health-related quality of life and treatment adherence.

Chronic Migraine as a Primary Chronic Pain Syndrome and Recommended Prophylactic Therapeutic Options: A Literature Review

“…A phase 3 RCT comparing the feasibility and short-term efficacy of mindfulness added to treatment as usual and usual treatment alone for CM patients indicated that adding mindfulness to treatment as usual was feasible with short-term efficacy versus treatment without mindfulness [ 150 ]. A clinical study aimed at examining neuropsychological and neuropsychiatric characteristics of CM patients during the interictal phase concluded that CM patients showed a higher rate compared to healthy controls in cognitive domains (such as sustained attention, information processing speed, visuospatial episodic memory, working memory, and verbal fluency) and depressive and anxiety symptoms [ 151 ]. In a case of CM, the integrated model and the pharmacological options together present beneficial management of the patients.…”