Page 171 - Migraine, the heart and the brain

differences represented different domains like psychomotor speed, executive function, language, attention, memory and visual processing. In our CAMERA-II study no difference were found between groups on memory, concentration, attention, executive function, psychomotor, processing speed, organization, fluid intelligence and visuospatial skills. Our study had the strength that it was large and investigators were blinded. The absence of impairment among migraineurs (and even a better global cognition) was recently shown in a large population study, results which were (partly) in line with our study.31
We were able to show (trend) that deep white matter lesions were associated with impaired memory function. This is in line with previous studies32 and underlines the sensitivity of used cognitive battery, as the amount of white matter lesions compared to non-migraine studies was limited.
If the impaired cognitive functions among migraineurs in these clinical based studies were the result of repeated migraine attacks, we hypothesized that impairment is more pronounced shortly after an attack. Therefore we studied cognitive function shortly after a migraine attack. (Chapter VIII). However no evidence for temporary changes in cognitive function could be found in the post-ictal state.
Our study design was unique as migraineurs were studied after the migraine attack, they had to be pain free. This allowed us to rule out any negative effect on cognitive function caused by pain itself. This however on the other hand led to an average of 17 hours following the end of the attack before testing. The use of controls was a strength of our study, in that way we were able to eliminate the effect of a learning effect.
We did however nd that migraineurs did not show the global precedence effect
(perceiving the global letter, which was built from a number of so called local letters
rst and faster) which was present in controls. In other words migraineurs were
impaired in seeing the wood for the trees. This may point towards dysfunction
of higher visual cortical areas or connectivity between areas involved in visual 9 processing. Our nding is in line with a study that migraineurs have higher thresholds
for the recognition of global shapes.33
Contrary to smaller studies, we could not demonstrate an impaired inter-ictal function of the cerebellum in (non-hemiplegic) migraine subjects, using several measurements sensitive for dysfunction of several cerebellar anatomic regions. Migraineurs did not differ from non-migraine controls for ne motor speed
Summary and general discussion
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