Selective attention of students suffering from primary headaches in a pain free period: a case control study

Abstract

Background:  Headache patients frequently complain about difficulties in attention and concentration, even when they are headache-free and psychometric studies concerning attentional deficits in headache patients between attacks are scarce. Objective:  To evaluate selective attention of headache patients in a pain free period and compare them with healthy volunteers. Subjects and Methods:  We performed, between February 2011 and July 2011, a case-control study, including 45 university students consulting for primary headaches, matched with 45 healthy students as controls. Headaches were classified according to the International Headache Society criteria (IHS, 2004). Subjects with a history of brain injury, epilepsy and visual disturbancies were excluded. Mood disorders were assessed using the Hospital Anxiety Depression (HAD) questionnaire. Selective attention was evaluated using the D-KEFS color-word interference test. Results:  Mean age of patients was 23.29 ± 2.55 years, versus 22.89 ± 2.04 years for controls (p = 0.2). Migraine and tension-type headaches were the only diagnosed headache types, respectively 55.56% and 44.44%. The selective attention score was -4.04 ± 7.08 for patients, versus -1.31 ± 7.73 for controls (p = 0.02). The mean mental flexibility score was lower in headache sufferers compared to controls (36.67 ± 6.79 versus 41.33 ± 6.23, p = 0.001). Gender, anxiety and depression scores, and temporal features of headache had no correlation with selective attention score. Conclusion:  Selective attention and mental flexibility capacities seem to be reduced in primary headache sufferers in pain free period. These findings could contribute to our understanding of the pathophysiology of primary headaches. Keywords: Selective attention, mental flexibility, neuropsychology, headache, migraine