Interictal cognitive event-related potentials in migraine subtypes: association with neuropsychiatric symptoms

Subjective cognitive decline is a common phenomenon among migraine patients. This study aimed to compare cognitive event-related potentials (CERP) across different migraine subtypes during the interictal phase and to evaluate their relationship with clinical and neuropsychiatric parameters.

A study was conducted involving 173 participants: 55 with migraine without aura (MwoA), 40 with migraine with aura (MwA), 23 with migraine aura without headache (MAwH), and 55 healthy controls (CG). CERP analysis included N200 and P300 latencies and amplitudes. Disease burden and comorbidities were assessed using the MIDAS, HIT-6, the Insomnia Severity Index (ISI), and the Hospital Anxiety and Depression Scale (HADS). All patients underwent brain MRI.

MwoA patients exhibited significantly prolonged N200 and P300 latencies alongside decreased P300 amplitudes compared to the CG. In contrast, while both MwA and MAwH patients also showed prolonged latencies across CERP components, with MwA demonstrating the longest latencies among all subtypes, their P300 amplitudes did not differ significantly from healthy controls. Notably, the MAwH group demonstrated significantly higher N200 and P300 amplitudes when compared directly to the MwoA group, achieving the highest overall values among the migraine subtypes. MwA demonstrated the longest latencies among all subtypes. Correlation analysis revealed that P300 latencies in MwoA were linked to attack frequency, while in MwA they correlated with disability scores (HIT-6, MIDAS). Notably, in the MAwH group, P300 parameters showed strong positive correlations with anxiety, depression, and insomnia scores. Across all subtypes, progressive latency prolongation was associated with longer disease duration.

Our findings confirm significant interictal disturbances in neuronal networks involved in cognitive processing. Furthermore, the strong correlation between CERP parameters and neuropsychiatric symptoms in MAwH suggests that psychological comorbidities are strongly linked to the modulation of neurophysiological responses in this specific subtype.