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Neuropsychological Functioning in Pediatric Primary Headache Disorders: A Meta-Analysis.

Jasmin H Pizer¹, Katherine A Hernandez¹, Stephen L Aita^2,3

¹University of South Alabama, Department of Psychology, Mobile, Alabama.

|April 2, 2025

Summary

Children and adolescents with primary headache disorders, particularly migraine, show poorer neuropsychological functioning across multiple cognitive domains compared to healthy peers.

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Area of Science:

Neuroscience
Pediatric Neurology
Cognitive Psychology

Background:

Adults with migraine often exhibit neuropsychological deficits.
Research on cognitive performance in pediatric primary headache disorders (PHD) is limited.
Understanding cognitive impacts in pediatric headache is crucial for effective management.

Purpose of the Study:

To systematically evaluate neuropsychological functioning in pediatric PHD.
To compare cognitive performance in children and adolescents with PHD versus controls.
To identify specific cognitive domains affected by pediatric primary headaches.

Main Methods:

A meta-analysis of 16 studies utilizing validated neuropsychological measures.
Inclusion of pediatric samples (<20 years) with and without PHD.
Data extraction and pooling using random-effects models.

Main Results:

Pediatric PHD samples demonstrated significantly worse overall neuropsychological performance (g = -0.31).
Deficits were observed across motor, executive function, learning/memory, language, processing speed, intelligence, and visuospatial domains.
Sensitivity analyses revealed that migraine samples drove these negative effects, not tension-type headache samples.

Conclusions:

Pediatric migraine is associated with generalized and domain-specific neurocognitive impairments.
Tension-type headache samples showed no significant cognitive deficits in this analysis.
Further research with larger tension-type headache cohorts is warranted.