Page 147 - Migraine, the heart and the brain

The post-ictal impact of a migraine attack on cognition
introduCtion
Many migraine patients report mild cognitive complaints, such as slowing of reaction and memory problems, during both the ictaland the post-ictal phase (1,2). Studies comparing cognitive functioning of migraine patients in the inter-ictal phase with controls are abundant but showed inconsistent ndings. Some studies reported inter- ictal cognitive de cits in the domains of psychomotor speed (1,3), executive function (4), language (5), visual processing (6), attention (2,3), and memory (2,7), while other studies demonstrated no differences in cognitive functioning between migraineurs and controls (8-10).
However studies of speci c after-effects of a migraine attack on cognitive functioning are scarce. One study investigating after-effects of a migraine attack failed to nd differences in cognitive function, even though patients did report subjective impairments (2). However, there is some evidence for post-ictal physiological alterations, like altered regional cerebral bloodflow (11) and reduced alpha activity in the electroencephalograph (12), which might suggest temporary cognitive de cits. The available ndings suggest a number of candidate processes but a systematic model of the impact of migraine on human information processing is lacking. Therefore, we chose a number of theoretically motivated, well-understood cognitive tasks that investigated the complete process from perception and attention to working memory.
The aim of the present study was to identify speci c cognitive processes (perceptual, attentional, or memory) that might be impaired by migraine attacks during the rst 48 hours after the attack, as compared to an inter-ictal baseline.
methods 8
Participants
Sixteen migraine patients diagnosed according to the International Headache Society (ICHD) II criteria (13) were recruited from the neurology headache outpatient clinic databases of the Leiden University Medical Center, Leiden, the Netherlands. Eighteen healthy controls were matched on age, gender, and educational level. Controls without a history of headache attacks were recruited among relatives of investigators and patients. Excluded were subjects who were: suffering from depression, illiterate, had a history of stroke or other brain injuries, or had more than 10 migraine days per
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