Subjects with migraine performed worse than controls on all tests. This result indicates changes in verbal memory and cued recall and recognition of verbal stimuli. Significant differences were detected in visuomotor selective attention and speed of processing information between groups, as measured by reaction time time in seconds on the TMTa and TMTb. On the TMT, there were no differences in error rates between groups. Migraineurs also scored significantly lower on the ST than controls.
There were no significant differences in word reading or ink color naming between groups. Lastly, regarding the VFT, patients with migraine displayed lower performance in the animals category. There were no significant differences in phonemic verbal fluency FAS test.
This result supports previous findings showing that children and adolescents with migraine have impaired short- and long-term verbal memory, speed of processing information, and selective and divided attention. Migraineurs are more affected by distractors during the learning process and have difficulties in recognition and recall. The poor test performance of migraineurs suggests deficits during registration, consolidation, and recall of verbal stimuli.
These deficits are associated with changes in the ability to organize thoughts and to use strategies to search for information. The impairment in short- and long-term memory in children with migraine may be linked to learning difficulties. Similar results have previously been reported. Deficits in visuomotor tracking and selective attention are consistent with the available data on adults 8 and children 17 with migraine, but one study found no significant differences in sequential and simultaneous information processing between children with migraine and controls.
To reconcile these findings, it is tempting to hypothesize that the speed of information processing might be the first sign of cognitive dysfunction in migraine. Over time, other cognitive domains may be progressively compromised. Interestingly, visuomotor processing speed has been reported to be one of the main deficits associated with white matter abnormalities. These are frequent unspecific findings described in brain magnetic resonance imaging studies of patients with migraine. Neuroimaging studies have found associations between white matter abnormalities and headache frequency in adults.
However, the migraine group showed poorer semantic verbal fluency performance animals. There are no consistent data in the literature on semantic verbal fluency in adolescents with migraine.
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Quantitative disparities found in semantic and phonological verbal fluency may suggest that the two groups have significant differences in long-term memory representation and strategies used during the retrieval process. Semantic fluency seems to depend more on access to semantic memory and its integrity than on executive processes, with greater temporal lobe activation. In phonological fluency, the process of searching requires the creation of non-habitual strategies based on lexical representation, also with greater frontal lobe activation.
The association between migraine and verbal functioning also appeared to impact later academic performance. The current study has several limitations, including its cross-sectional design and small sample size.
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The restrictive study inclusion criteria, i. The study is clinic-based where patients were drawn from a referral center where more severe or disabling cases are usually followed. Therefore, the current findings must be viewed with caution as they do not necessarily reflect the cognitive status of patients in the community or individuals with milder forms of migraine. Future studies involving larger samples and enrollment of subjects from the community are warranted to overcome these limitations.
In conclusion, the current results suggest that children and teenagers with migraine may exhibit cognitive symptoms. We would like to thank all the participants and their families for their collaboration in the study. Author contribution. Pediatric migraine variants: a review of epidemiology, diagnosis, treatment, and outcome.
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