Exploring the Interictal Neuropsychological Burden of Pediatric Migraine

Migraine in childhood and adolescence is a common neurological disorder extending beyond headache attacks, often affecting cognitive, emotional, and behavioral functioning during the interictal phase. Although migraine-related disability and school absenteeism are well recognized, comprehensive multidimensional assessments are limited, especially in non-Western populations. To examine the interictal burden of pediatric migraine by evaluating executive functions, emotional-behavioral symptoms, and attention-deficit/hyperactivity disorder (ADHD)-related features using standardized psychometric tools.

This cross-sectional study included 71 adolescents (mean age 14.6 ± 1.9 years; 70.4% female) diagnosed with migraine based on International Classification of Headache Disorders, 3rd edition criteria. Migraine-related disability and impact were measured with the Pediatric Migraine Disability Assessment (PedMIDAS) and Headache Impact Test (HIT-6). Executive functions were assessed using the Teenage Executive Functioning Inventory (TEXI), emotional-behavioral symptoms with the Strengths and Difficulties Questionnaire (SDQ), and ADHD-related features with the Conners Parent Rating Scale-Short Form. Correlation, group comparison, and multiple regression analyses explored associations between migraine severity, headache frequency, and psychometric outcomes.

PedMIDAS and HIT-6 indicated moderate-to-severe migraine burden. HIT-6 correlated with TEXI inhibition, Conners total, ADHD index, and SDQ emotional symptoms. PedMIDAS correlated with SDQ emotional and hyperactivity subscales. Headache frequency was associated with TEXI total and SDQ total scores. Girls had higher PedMIDAS and TEXI inhibition, while boys scored higher on Conners hyperactivity. Regression analyses revealed directional but nonsignificant relationships after adjusting for confounders.

Pediatric migraine imposes a considerable interictal burden, influencing executive, emotional, and behavioral domains. Multidimensional evaluation and integrated management approaches are essential to address both medical and psychosocial impacts.