Migraines and headaches have an effect on people's everyday well-being and livelihood, thus this is a topic of interest to cognitive researchers because it is a condition that is difficult to quantify but has an effect not only on the individual’s well-being but also on the way they process information on a cognitive level.
On the individual level, headaches cause pain and impact daily life. On the societal level, it has been estimated that headaches cost 173billion euros annually, a figure that is based only for Europe and has likely risen (Linde et al., 2012).
Researching Cognition in Migraine & Headache Patients
Cognitive processes are associated with certain brain areas. For example, visual attention strongly depends on the occipital lobe while language is associated with Broca’s and Wernicke’s areas. Since headaches are known to impact how the brain functions on a chemical level, cognitive processes are bound to be affected.
In fact, there is a large body of evidence that shows that headaches and migraines negatively affect cognitive processes. By understanding how cognition is affected by headaches and migraines, more targeted treatments and interventions can be created in order to increase the individual’s well-being.
Typically, treating headaches and migraines is all about having the pain subside. And while this is important, more and more researchers are suggesting that addressing cognitive dysfunction should also become a therapeutic target for handling headaches and migraines (Gil-Gouveia & Martins, 2019).
What have researchers discovered about how cognitive processes are impacted in headache and migraine sufferers? Let's take a look.
Cognitive Processes Impacted By Headache / Migraine Episodes
Different types of research, such as pharmacological and neurophysiological studies, have confirmed that there are clear-cut clinical symptoms of cognitive impairment in people who suffer from headaches and migraines which affects cognitive processes like attention and executive function. However, longitudinal studies have shown that there is no progressive cognitive decline in chronic patients, indicating that in the long-term individuals are not deteriorating mentally (Vuralli, Ayata, & Bolay, 2018).
Significant differences have been found when comparing normal controls’ cognitive processes to those of headache and migraine sufferers.
Headaches impact results on cognitive tasks like the flanker task, the attentional switching task, the n-back task, and more.
For example, in the flanker task, responses are significantly slower and in the attentional switching task more errors occur in headache and migraine patients. Interestingly, some other measurements are not impacted by headaches. For example, the final results in the flanker task and the magnitude of the attentional switching effect remain intact. These subtle differences demonstrate that even though cognition is significantly affected by headaches and migraines, this touches only certain areas (Moore, Keogh, & Eccleston, 2013).
Given the sensitivity of this patient group, one feasible approach to study how cognition changes during headache and migraine episodes is to incorporate remote, online studies. Labvanced allows you to easily design your own and offers many cognitive pre-made tests that can be imported in your study, such as the ones mentioned previously:
Assessing Cognition in Treatment Interventions for Headaches / Migraines
When assessing interventions for headaches and migraines, quantifying cognitive processes is now increasingly being considered as an important outcome, in addition to classic measurements such as pain reduction.
One popular non-pharmaceutical intervention for headaches is mindfulness cognitive behavioral therapy (MCBT) which can significantly decrease the cognitive dysfunction that accompanies headaches (Day & Thorn, 2017).
Researchers are also looking at how headache pain is often accompanied by neck pain and are considering physiotherapeutic techniques as a method of intervention (Castien & De Hertogh, 2019).
Conclusion
While changes are observed on the individual level, especially while a headache episode is occurring, population studies have shown that there is no significant long-term effect (Gaist et al., 2005). This may be a reason why the push for interventions is not as strong as for other diseases such as Alzheimer’s. However, given the economic burden and the impact on one’s quality of life, it is still an important condition to address therapeutically, especially through the lens of cognition. Online studies can make studying this population group, along with the effect of intervention, more easy for both the researchers and the participants.
References
Castien, R., & De Hertogh, W. (2019). A neuroscience perspective of physical treatment of headache and neck pain. Frontiers in neurology, 10, 276.
Day, M. A., & Thorn, B. E. (2017). Mindfulness-based cognitive therapy for headache pain: An evaluation of the long-term maintenance of effects. Complementary therapies in medicine, 33, 94-98.
Gaist, D., Pedersen, L., Madsen, C., Tsiropoulos, I., Bak, S., Sindrup, S., ... & Christensen, K. (2005). Long-term effects of migraine on cognitive function: a population-based study of Danish twins. Neurology, 64(4), 600-607.
Gil-Gouveia, R., & Martins, I. P. (2019). Cognition and cognitive impairment in migraine. Current pain and headache reports, 23(11), 1-10.
Linde, M., Gustavsson, A., Stovner, L. J., Steiner, T. J., Barré, J., Katsarava, Z., ... & Andrée, C. (2012). The cost of headache disorders in Europe: the Eurolight project. European journal of neurology, 19(5), 703-711.
Moore, D. J., Keogh, E., & Eccleston, C. (2013). Headache impairs attentional performance. PAIN®, 154(9), 1840-1845.
Sommer, B. R., Mitchell, E. L., & Wroolie, T. E. (2013). Topiramate: Effects on cognition in patients with epilepsy, migraine headache and obesity. Therapeutic advances in neurological disorders, 6(4), 211-227.
Vuralli, D., Ayata, C., & Bolay, H. (2018). Cognitive dysfunction and migraine. The journal of headache and pain, 19(1), 1-14.