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Cognitive Decline in Chronic Migraine with Nonsteroid Anti-inflammation Drug Overuse: A Cross-Sectional Study

Xiaoying Cai1,2, Xiaotian Xu2, Aiwu Zhang2

  • 1Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou 510080, China.

Pain Research & Management
|June 15, 2019
PubMed
Abstract

Insights

Chronic migraine patients face increased cognitive decline risk. Medication overuse did not impact cognitive performance in chronic migraine sufferers, but anxiety and depression were higher in those with medication overuse headaches.

Area of Science:

  • Neurology
  • Neuroscience
  • Cognitive Science

Background:

  • Chronic migraine with medication overuse headache (CM-MOH) is a prevalent form of chronic migraine.
  • CM-MOH is associated with increased risks of stroke and white matter lesions, potentially leading to cognitive decline.
  • The precise impact of CM-MOH on cognitive function remains incompletely understood.

Purpose of the Study:

  • To investigate and define the cognitive performance alterations in patients with CM-MOH.
  • To compare cognitive functions across different migraine subgroups and healthy controls.

Main Methods:

  • A cross-sectional study involving 116 participants, including CM-MOH, chronic migraine without medication overuse (CMwoMOH), migraine without aura (MO), and control groups.
  • Cognitive function assessed using Addenbrooke's Cognitive Examination Test (ACE-R), Trail Making Test A/B (TMT A/B), and Digit Symbol Test (DST) during interictal periods.
  • Data collection included headache characteristics, anxiety, depression, and sleep and life quality assessments.

Main Results:

  • Chronic migraine (CM) patients exhibited a higher risk of cognitive decline compared to controls, particularly in ACE-R scores and language fluency.
  • Patients with CM-MOH showed increased risks of memory and executive dysfunction.
  • No significant cognitive differences were found between CM-MOH and CMwoMOH groups; however, CM-MOH patients reported higher anxiety, depression, and poorer sleep and life quality compared to MO patients.

Conclusions:

  • Cognitive decline is a significant risk associated with chronic migraine.
  • Medication overuse, specifically nonsteroidal anti-inflammatory drugs, did not independently influence cognitive performance in chronic migraine sufferers.
  • While medication overuse itself may not directly impair cognition in CM, the associated psychological distress and quality of life factors warrant attention.

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