Cognitive Function and White Matter Lesions in Medication-Overuse Headache.

Area of Science:

• Neurology
• Neuroscience
• Radiology

Background:

• Medication-overuse headache (MOH) is a prevalent condition associated with neurological complications.
• Cognitive dysfunction and white matter lesions (WMLs) are increasingly recognized in MOH patients.
• Understanding the relationship between cognitive function and WMLs is crucial for managing MOH.

Purpose of the Study:

• To investigate cognitive function in medication-overuse headache (MOH) patients.
• To assess white matter lesions (WMLs) in MOH patients using MRI.
• To explore the relationship between cognitive function and WMLs in MOH.

Main Methods:

• Participants underwent cognitive assessments including the Montreal Cognitive Assessment (MoCA).
• Anxiety, depression, and sleep quality were evaluated using standardized scales (HAMA, HAMD-24, PSQI).
• Brain MRI scans were performed to quantify WMLs using the Fazekas scale, categorizing participants into healthy controls, MOH with normal cognition, and MOH with cognitive impairment groups.

Main Results:

• MOH patients demonstrated significantly lower MoCA scores compared to healthy controls, particularly in visuospatial function, executive function, attention, and orientation.
• MOH patients exhibited higher scores for anxiety (HAMA), depression (HAMD-24), sleep disturbances (PSQI), and deep white matter hyperintensities.
• Cognitive impairment in MOH was associated with older age, longer disease duration, more frequent monthly headache days, and greater WML burden (Fazekas scale scores). Disease duration and monthly headache days were identified as significant predictors of cognitive impairment.

Conclusions:

• Medication-overuse headache is associated with significant cognitive impairment and an increased burden of white matter lesions.
• Cognitive function in MOH patients is negatively correlated with the extent of WMLs.
• Disease duration and monthly headache frequency are key predictors of cognitive impairment in MOH, suggesting that timely and effective treatment may mitigate these deficits.