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Are Migraine Related Changes Related to Impaired Cognition?

Posted on 04. May, 2013 by in Headaches

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A recent study titled “Structural Brain Changes in Migraine,” appears in The Journal of the American Medical Association, November 14, 2012, vol. 308, no. 13, pp. 1189-1897, by Inge H. Palm-Meinders et al.

The study set out to follow-up the 2000 Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis cohort (CAMERA-1), a prospective population based observational study of Dutch participants with migraine and an age and sex matched control group. This study showed that women with migraines were more likely to have scattered areas of white mater changes on MRI scans.

The current study is known as CAMERA-2 and the researchers wanted to determine  whether women or men with migraine have a higher incidence of brain lesions 9 years after initial MRI, whether migraine frequency was associated with progression of brain lesions, and whether progression of brain lesions was associated with cognitive decline.

The study determined that  women with migraines did not appear to experience a decline in cognitive ability over time compared to those who don’t have migraines. Standardized measures of cognitive abilities including concentration, memory, and attention did not show significant losses among people with migraine-associated lesions compared to those without migraine. Further, the study showed that women who have migraines had a higher likelihood of having brain changes that appeared as bright spots on MRI. In addition, there was no association of migraine with progression of any MRI-measured brain lesions in men. Although women participants with migraine  were more likely to have hyperintensities, there was no clear relation to the frequency of migraine attacks, the type of migraine, or how they were treated.

The brain changes that cause bright spots seen on MRI for women with migraine are unknown and more research is needed. An issue with this study is that age is a risk factor for white matter changes and this was difficult to tease out. Many questions still remain but progressively related small blood vessel changes may be causing migraine in women.

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