Interictal and Postictal Cognitive Changes in Migraine

Mulder, E.G.; Linssen, W.H.J.P.; Passchier, Jan; Orlebeke, JF; de Geus, EJC · 1999 · OpenAlex-citations

DOI: 10.1046/j.1468-2982.1999.019006557.x

archive: archived pipeline: cataloged verified

Get this paper ↗ (DOI — opens at the source; we link to it, we don't host it)

Summary

This study investigates whether migraine patients exhibit cognitive impairments during symptom-free (interictal) periods compared to healthy controls, and whether these impairments are transiently exacerbated following a migraine attack. The research was motivated by inconsistent prior findings regarding cognitive deficits in migraine, which may have been confounded by patient selection biases, lack of distinction between migraine subtypes, and failure to account for post-attack physiological recovery phases. Specifically, the authors sought to determine if cognitive performance differences were related to attack duration, severity, or medication type. The study included 20 migraineurs without aura, 10 migraineurs with aura, and 30 matched headache-free controls. Participants were assessed using the Neuropsychological Evaluation System (NES2), which measures cognitive, memory, learning, and psychomotor functions. Testing occurred during three sessions: a baseline interictal session, and two postictal sessions conducted within 30 hours of a migraine attack. One postictal session followed treatment with sumatriptan, and the other followed habitual nonvasoactive medication (e.g., aspirin). The order of medication conditions was counterbalanced. Data were analyzed using Principal Component Analysis to cluster variables into domains such as reasoning, reaction speed, selective attention, and pattern perception, followed by ANOVAs to compare groups and sessions. Results indicated that during the interictal period, migraineurs without aura performed with speed comparable to controls. In contrast, migraineurs with aura exhibited significantly slower response times than controls in tasks requiring selective attention (continuous performance tasks and color word task) and the symbol digit substitution task. These deficits were attributed to impaired selective attention and sustained attention rather than general motor slowing, as motor functioning differences were minimal. Crucially, these interictal cognitive impairments in migraineurs with aura were not aggravated by the preceding migraine attack. Postictal cognitive performance did not differ significantly from baseline performance, regardless of whether sumatriptan or usual medication was used. While sumatriptan shortened attack duration compared to usual medication, it did not alter the pattern of cognitive deficits. The study concludes that migraineurs with aura suffer from specific, stable cognitive deficits in selective and sustained attention during symptom-free periods, likely reflecting functional disturbances in prefrontal cerebral areas. These deficits are not transient consequences of the migraine attack itself, nor are they influenced by the type of acute medication used. The findings suggest that cognitive impairments in migraine are subtype-specific and persistent, rather than being solely postictal phenomena. This distinction is critical for understanding the neurophysiological impact of migraine and for interpreting neuropsychological assessments in this population.

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed.

Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• cognitive impairment