In search of a neuropsychological profile for migraine: A scoping review

Objective

Migraine is commonly overlooked by the general population and by professionals in research and clinical practice. Moreover, it is difficult to grasp the neuropsychological profile of migraineurs due to the cyclic nature of the disorder. With this in mind, a scoping review of the literature was conducted with the goal of characterizing cognitive domains associated with deficits in migraine.

Methods

PubMed, PsychInfo, Scopus, EMBASE and OpenGrey databases were searched for studies published from 1st January 2006 to 30th November 2022. Following the review process, 52 eligible studies were included in the review.

Results

Studies included in this review show mixed and sometimes contradictory findings. Overall, both visual and auditory perception appear to be impaired. Deficits on attention, many memory processes, visuospatial function and spatial navigation and on a wide range of executive functions (set-shifting and cognitive flexibility, decision-making and reasoning, working memory and prospective memory) complete a complex cognitive profile in migraine. Lack of consistency across studies in sample selection and sizes, lack of detailed links between cognitive deficits and specific migraine phases, or length and chronicity, inconsistencies on the role of aura in cognitive function; and heterogeneity and sometimes questionable reliability and validity of some of the cognitive measures used may affect the clarity and consistency of results observed.

Conclusion

Further research properly addressing the role of gender and age, migraine stage, length and chronicity of the condition, the effect of aura and comorbidities is needed, alongside increasing consistency across diverse neuropsychological assessment protocols.

Significance

This review provides a comprehensive, up-to-date picture of the current status of knowledge in relation to the characterization of the complex cognitive profile of migraine. It offers detailed information of the existing research gaps and challenges to improve the cognitive characterization of migraine across its different stages and leads clinicians to carefully consider the selection of relevant cognitive tasks, in order to grasp more accurately the patient’s cognitive profile; an assessment that should be an integral part of any protocol developed for the clinical assessment and subsequent treatment planning for migraine.