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Assessment of cognitive dysfunction during migraine attacks: a systematic review

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Abstract

Patients consistently report cognitive impairment during migraine attacks, yet the documentation of such dysfunction by neuropsychological evaluation has lacked similar consistency. This incongruence may be due to discrepant study designs, assessment tools and small samples sizes. To search for evidence of decline in cognitive functions during a migraine attack, compared to headache-free performance. The secondary objective was to determine if the eventual decline had a consistent neuropsychological pattern. Systematic review of the medical literature using PubMed and Cochrane library databases without limitations or restrictions from inception to March 2014, using the search terms “migraine”, “cognition”, “neuropsychological”. We included studies in episodic migraine that had a neuropsychological evaluation performed during an attack. From 1,023 titles screened, a total of 10 articles met criteria for inclusion and were fully reviewed. Only five of these studies, comprising a total of 163 individuals, had enough data to allow an appraisal of the study question. All five studies were positive in documenting some type of reversible cognitive impairment during the migraine attack. The pattern of cognitive impairment most often documented was of executive dysfunction, but the presence of bias induced by the choice of tests and of small samples prevents this finding from being conclusive. This review supports the existence of reversible cognitive dysfunction during the migraine attack, corroborating patients’ subjective descriptions. Further work is needed to establish the pattern of cognitive dysfunction, their underling pathophysiological mechanisms and the impact of these symptoms in migraine-associated disability.

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Conflicts of interest

The authors have no conflicts of interest regarding this study. This study was not funded. Raquel Gil-Gouveia reports no disclosures. Isabel P. Martins reports no disclosures. António G. Oliveira reports no disclosures.

Ethical standard

The manuscript does not contain unpublished clinical studies or patient data. This manuscript reviews published clinical studies that compile to the required Ethical Guidelines.

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Authors and Affiliations

  1. Department of Clinical Neurosciences, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal

    Raquel Gil-Gouveia & Isabel Pavão Martins

  2. Headache Center, Hospital da Luz, Lisbon, Portugal

    Raquel Gil-Gouveia

  3. Pharmacy Department, Universidade Federal do Rio Grande do Norte, Natal, Brazil

    António G. Oliveira

Authors
  1. Raquel Gil-Gouveia
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  2. António G. Oliveira
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  3. Isabel Pavão Martins
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Correspondence to Raquel Gil-Gouveia.

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Gil-Gouveia, R., Oliveira, A.G. & Martins, I.P. Assessment of cognitive dysfunction during migraine attacks: a systematic review. J Neurol 262, 654–665 (2015). https://doi.org/10.1007/s00415-014-7603-5

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  • DOI: https://doi.org/10.1007/s00415-014-7603-5

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