Study On Cognitive Dysfunction In Migraineurs

Background:Migraine is a cerebral dysfunction disorder with abnormal sensory system.It is also one of the most common types of primary headaches in neurology The results of the Global Burden of Disease study showed that migraine ranked second for the impact on worldwide disability adjusted life year(DALY)of neurological disorders.Migraine has a great influence on the work and life of migraineurs because of its recurrent and severe pain.Migraineurs often complain of cognitive impairment.Psychological disorders such as anxiety and depression are common comorbidities of migraine.The impact of migraine on cognition is being gradually recognized.So far,many studies have investigated cognitive impairment in migraineurs,but the results are inconsistent.This cross-sectional study aims to explore the relationship between migraine and cognitive dysfunction.Objective:To investigate the cognitive function of migraineurs,analyze its relationship with headache clinical characteristics,headache-related disability,and psychological disorders,and explore the influencing factors of cognitive function in migraineurs.Methods:From June 2019 to January 2020,117 patients with primary headache were enrolled in the headache clinic of Department of Neurology,Shandong Provincial Hospital,including 87 migraine patients(70 migraine patients without aura,17 migraine patients with aura),and 30 tension-type headache(TTH)patients.Thirty people were selected as the healthy control group from the accompanying staff of the patients and the examinees of the physical examination center.General information,headache clinical characteristics,assessments of headache-related disability,psychological symptoms and cognitive function and other relevant data were collected for statistical analysis.Results:(1)Headache clinical characteristics and assessment of headache-related disability:There was no significant difference between migraine group and TTH group in age of onset,course of disease and preventive treatment(all P>0.05).The most common(P=0.003)and the most severe degree of pain(P=0.001)in migraine group were both higher than those in TTH group.The most common duration(P=0.025)and the most severe duration(P=0.044)of headache attacks in migraine group were both shorter than those in TTH group.The frequency of headache attacks in migraine group were lower than in TTH group(P<0.001).Headache Impact Test-6(HIT-6)score in migraine group was higher than in TTH group(P=0.001),but there was no significant difference in Migraine Disability Assessment Questionnaire(MIDAS)scores(P=0.375).(2)Assessment of cognitive function:There was no significant difference between migraine group and TTH group in Montreal Cognitive Assessment(MoCA)total score,visuospatial and executive functions,language and delayed recall scores(all P>0.05).Scores of the above items in both groups were lower than those in healthy control group(all P<0.05).There was no significant difference in naming,attention,abstraction and orientation scores among the three groups(all P>0.05).(3)Assessment of psychological symptoms There was no significant difference between migraine group and TTH group in Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder Questionnaire-7(GAD-7)scores(all P>0.05).PHQ-9 and GAD-7 scores in both groups were higher than those in healthy control group(all P<0.001).(4)Correlation between cognitive function and headache-related disability and psychological symptoms in migraineurs:MoCA total score,visuospatial and executive functions,naming,attention,language,abstraction and delayed recall scores were not correlated with HIT-6,MIDAS,PHQ-9 and GAD-7 scores in migraine patients(all P>0.0125)Orientation score was correlated with HIT-6,MIDAS and PHQ-9 scores(P<0.001,P=0.003 and P=0.003,respectively),and orientation score was not correlated with GAD-7 score(P=0.034).(5)Influencing factors of cognitive function in migraineurs Through multiple linear regression analysis,it was concluded that age affected MoCA total score,visuospatial and executive functions,attention,language and delayed recall scores.And attack duration affected MoCA total score,visuospatial and executive functions,language,abstraction and delayed recall scores.Aura mainly affected the visuospatial and executive functions of migraineurs,while topiramate administration was mainly related to impaired language function of migraineurs Conclusion:(1)The degree of pain in migraine patients was higher than in TTH patients,while the duration and frequency of headache attacks in migraine patients were shorter and lower than those in TTH patients.There was no significant difference between migraine and TTH in the impact on social function of patients,but in other aspects of daily life such as vitality,migraine had a greater subjective impact than TTH.(2)There was no significant difference in cognitive function between migraine patients and TTH patients,and the cognitive levels of both groups were lower than that of healthy people,especially in visuospatial and executive functions,language,and delayed recall,while in naming,attention,abstraction and orientation,there was no significant difference among these three groups.(3)There was no significant difference in the assessment of psychological symptoms between migraine patients and TTH patients,and the scores of anxiety and depression in both patients were higher than those in healthy people.(4)There was no correlation between the overall cognitive level of migraineurs and headache-related disability.Although orientation function was related to depression score,there was no correlation between the overall cognitive level and psychological symptoms in migraineurs.(5)Age and duration of attack had a wide influence on the overall and various fields of cognition in migraineurs.Aura mainly affected the visuospatial and executive functions of migraineurs,while topiramate administration was mainly related to impaired language function of migraineurs.