Reversible Cognitive Decline Accompanies Migraine and Cluster Headaches

• Published in: Headache 2000-09, Vol.40 (8), p.638-646
• Main Authors: Meyer, John S., Thornby, John, Crawford, Kate, Rauch, Gaiane M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; chronic daily headache; cluster; Cluster Headache - psychology; Cognition Disorders - etiology; cognitive impairment; disability; Female; Humans; Male; Medical sciences; Mental Status Schedule; Middle Aged; migraine; Migraine Disorders - psychology; Neurology; Neuropsychological Tests; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0017-8748; 1526-4610
• DOI: 10.1046/j.1526-4610.2000.040008638.x

Vascular headaches, including migraine, cluster, and migrainous transformation to chronic daily headaches, are disabling. During and shortly after headache intervals, difficulties are reported in concentration, comprehension, and communication, not accounted for by nausea, photophobia, or sonophobia. These interfere with interpersonal relations and performance at work with economic loss. The hypothesis tested and reported here is that cognitive impairments comprise an important part of vascular headache diatheses. One hundred ninety‐six otherwise normative subjects suffering from migraine or cluster, but not tension‐type, headaches (136 women, 63 men; mean age, 46 years) participated in an outpatient prospective trial. One hundred thirty‐three patients had migraine without aura, 39 migraine with aura, 11 periodic cluster (by IHS criteria), and 13 had migrainous transformation into chronic daily headaches. Neuropsychological testing was compared with and without headaches, by combined Mini‐Mental Status Examination (MMSE), Cognitive Capacity Screening Examination (CCSE), and Hamilton Depression Rating Scale (HDRS). During headache intervals, significant decline was measured in both CCSE and MMSE scores (P