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Neuropsychological Function in Migraine Headaches: An Expanded Comprehensive Multidomain Meta-Analysis

Jasmin H Pizer1, Stephen L Aita1, Melissa A Myers1

  • 1From the Department of Psychology (J.H.P., M.A.M., N.A.H., V.C.I., K.M.B., K.A.H., B.D.H.), University of South Alabama, Mobile; Department of Mental Health (S.L.A.), VA Maine Healthcare System, Augusta; Department of Psychology (S.L.A.), University of Maine, Orono; Department of Neuroscience (K.A.H.), Ochsner Health Center, Baton Rouge, LA; Alzheimer's Disease Research Center (E.C.P.), Boston University, MA; Department of Psychological Science (T.O., N.C.B.), Texas Tech University, Lubbock; and Department of Psychology (T.A.S.), University of Mississippi, Oxford.

Neurology
|January 22, 2024
PubMed
Summary

Persons with migraine (PwM) exhibit lower cognitive performance compared to healthy controls (HCs), particularly in executive function and processing speed. These cognitive deficits are more pronounced in clinical samples and are not significantly associated with aura status.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Epidemiology

Background:

  • Existing literature on neuropsychological function in persons with migraine (PwM) is extensive but lacks comprehensive quantitative syntheses.
  • This study addresses this gap by conducting an expanded meta-analysis to compare cognitive performance between PwM and healthy controls (HCs).

Approach:

  • A systematic literature search was performed across multiple databases up to August 1, 2023, adhering to Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines.
  • Random-effects modeling was used to analyze aggregated effect sizes (Hedges' *g*), assess heterogeneity (Cochran *Q*, *I*2), explore moderators (meta-regression, subgroup analyses), and evaluate publication bias.
  • Study quality was assessed using NIH tools.

Key Points:

  • The meta-analysis of 58 studies (5,452 PwM, 16,647 HCs) revealed significantly lower overall cognitive performance in PwM (g = -0.37).
  • Domain-specific deficits were observed in global cognition, executive function, processing speed, visuospatial skills, attention, learning/memory, and language.
  • Cognitive impairments were more pronounced in clinic-based samples versus community samples and were associated with younger age of HCs and longer attack duration in PwM.

Conclusions:

  • Persons with migraine demonstrate impaired neurocognition, particularly in executive functioning and processing speed, when compared to healthy controls.
  • The observed cognitive effects are generally small to moderate and are more evident in clinical settings.
  • Migraine aura status was not found to be a significant factor associated with the degree of neurocognitive impairment.