Neuropsychological functioning in migraine headache, nonheadache chronic pain, and mild traumatic brain injury patients

There are conflicting reports in the literature concerning the neuropsychol ogical functioning of migraine headache patients. The finding in some studi es that migraineurs performed more poorly than healthy controls led to the hypothesis that chronic migraine may result in subtle but persistent cerebr al dysfunction. Reports describing acute and between-headache neurophysiolo gical disturbances in migraineurs lent support to this hypothesis. To eluci date the cognitive status of these patients, we administered a brief neurop sychological battery to 60 individuals with migraine headache (HA), nonhead ache chronic pain (PAIN), or mild traumatic brain injury (MTBI). The PAIN g roup was included to test the hypothesis that cognitive difficulty in migra ineurs might result from the discomfort, depression, medications, etc. ofte n associated with chronic pain, rather than from brain dysfunction. The MTB I patients were considered a useful comparison for the migraineurs because their level of impairment was also expected to be mild, at worst A MANOVA, with three cognitive index scores as the dependent variables, revealed that the three groups differed significantly. Follow-up contrasts demonstrated that the MTBI group was significantly more impaired on the memory index com pared to the HA and PAIN groups, which did not differ from each other. The use of two different normative-based cutoffs to identify individuals who we re impaired on the test battery revealed that the frequency of impairment w ithin the two groups of pain patients, but not the MTBI patients, was withi n normal limits. Thus, the results did not support a link between migraine headache and cognitive impairment (C) 1999 National Academy of Neuropsychol ogy. Published by Elsevier Science Ltd.