Page 21 - Migraine, the heart and the brain

Migraine and inter-ictal cognitive function. 1 Studies comparing cognitive functioning of migraine patients in the interictal phase
with controls are abundant but have shown inconsistent ndings. One of the aims of
this thesis was to investigate if migraine subjects had an impaired cognitive function
compared to controls, and whether brain changes found with MRI in migraine subjects were associated with impaired cognitive function (Chapter II)
Migraine and impaired post-ictal cognitive function.
The CAMERA-study investigated cognitive function in migraine not related to an attack (inter-ictally). I investigated also speci c post-ictal effects of the migraine attack, in a separate study. Many migraine patients report mild cognitive complaints, like slowing of reaction and memory problems, during both the ictal- and the post- ictal phase.65;66 One study investigating after-effects of a migraine attack failed to nd differences in cognitive function, even though patients did report subjective impairments.66 The available ndings suggest a number of candidate processes but a systematic model on the impact of migraine on human information processing is lacking. In Chapter VIII a number of theoretically motivated, well understood cognitive tasks are described, that allowed us to track most of the processing stream from perception over attention to working memory.
White matter hyperintensities and cognitive function and migraine
Several studies report a relation between the presence of white matter hyperintensities (WMH) and decreased cognitive function.67;68 However, the presence of WMH among younger people is rare and therefore the number of studies on this subject among healthy, younger adults from the general population is limited. In our cohort of migraineurs and controls, we had the opportunity to evaluate the cognitive performance in younger, healthy participants from the general population and to assess whether there is an association with the presence of WMH (deep as well as periventricular). Furthermore, we were able to evaluate the role of having migraine on this association. (Chapter II)
Migraine and cerebellar function
Several studies showed that subclinical cerebellar ischemic lesions were more prevalent in migraineurs than controls.18;69 Furthermore impaired cerebellar functions were reported in migraineurs in other studies.62;70;71 So far, direct comparison between these ischemic lesions and functional cerebellar outcomes in migraineurs was lacking.
Introduction
19