Cognitive and Emotional Disorders in Patients with Migraine and Signs of Leukoencephalopathy

Pozhidaev K. A.; Parfenov V. A.

摘要

Objective. To identify cognitive and/or emotional impairments and their relationships with neuroimaging features in chronic migraine. Materials and methods. Fifty patients (eight men and 42 women, mean age 41.9 ± 11.9 years) with migraine (predominantly chronic) and MRI signs of leukoencephalopathy were followed over a period of six months. The control group consisted of 40 healthy people (13 men and 27 women) aged 20–64 years (mean age 42.6 ± 12.0 years). Neuropsychological investigations (the 12-word test, literal and categorial associations, the Benton test, the Münsterberg test, the MoCA, the trail-making test, the forward and reverse number memorization test, the digit symbol substitution test, and the Stroop color test) and assessments of emotional impairments (Beck Depression Inventory (BDI), CES-D depression scale, the Hospital Anxiety and Depression Scale (HADS), and the Spielberger–Hanin State-Trait Inventory (STI)) were performed at baseline and at three and six months of preventive therapy of migraine. Results and discussion. Migraine patients scored lower values on the MoCA (p = 0.004), the 12-word memorization test (p = 0.0003), and the literal (p = 0.001) and categorial (p = 0.0002) associations tests than controls. There was no significant relationship between the volume of white matter damage in the brain on MRI scans and the severity of cognitive impairments. An inverse correlation was found between the mean extent (correlation coefficient R = –0.41) between the number of headache days per month and MoCA scores (p < 0.05). Migraine patients showed signs of depression on the HADS (p = 0.04), BDI (p = 0.003), and CES-D (p = 0.001), with increases in anxiety on the HADS (p = 0.0001) and STI (p = 0.0001). A significant relationship was found between the severity of depression and MoCA scores (p = 0.007). Preventive therapy for six months reduced the frequency of headache from 19.4 ± 2.9 to 12.6 ± 4.4 days per month (p < 0.05) and significantly decreased the severity of emotional disorders and improved cognitive functions on most neuropsychological tests (the MoCA, 12-words test, Münsterberg test, part B of the trail-making test) as compared with baseline data. Conclusions. Preventive therapy of migraine decreased the frequency of headache attacks and reduced the severity of emotional and cognitive impairments. Prophylactic treatment of migraine and concomitant emotional disorders is the most effective pathway to improving cognitive functions.

Cognitive and Emotional Disorders in Patients with Migraine and Signs of Leukoencephalopathy

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