MIGRAINE: A POSSIBLE CAUSE FOR COGNITIVE DECLINE
Keywords:Migraine, Cognition, Stroop test, Obesity
Objectives:Migraine is the second most common type of headache and seventh most disabling disease worldwide. In general, obesity is often related to headache disorders in several clinical and epidemiologic studies. Obese migraine patients may have an increased attack frequency due to increase in inflammatory response. Cognitive decline is the major pitfall of migraine disorder and there exists a conflicting result between cognition and migraine and the effect of Body Mass Index (BMI) on migraine. So this study is done to find out the relationship between cognition and migraine and its association with BMI.
Methods:The study protocol was approved by the ethical committee of SRM Medical College Hospital & Research Centre. The study group consisted of 30 migraine patients and 30 healthy controls aged between 18-40 years of age. Informed consent was obtained from all the participants. Diagnosis of migraine was made using the criteria of 2nd edition of International Headache Classification (IHC). Patients affected by Diabetes mellitus, Hypertension, allergy, inflammation, infection or immune disorders were excluded. Height and weight of the subjects were taken to calculate the BMI. Cognitive tests such as stroop interference trial & trial making tests (A&B) were done to evaluate working memory, mental flexibility and attention.
Results:Compared to controls, cases took more time for performing stroop colour card test (106.40 Â± 15.87 seconds vs. 132.17Â±7.027seconds, p<0.001) and trial making pattern B (54.77Â± 8.169 seconds vs. 56.23 Â± 23.457seconds, p=0.004). Among the migraine subjects, obese individuals had an increased frequency of migraine attack per month (Correlation coefficient r=0.797)
Conclusion:Cognitive decline in migraine is one of the underestimated problems in migraine. Identifying such problems early can prevent major consequences in day to day activities of migraine patients. Since there is an increased frequency of migraine with increase in BMI, obese migraine subjects can be recommended to do regular exercises.
Baldacci F, Lucchesi C, Cafalli M, Poletti M, Ulivi M, Vedovello M, Giuntini M, Mazzucchi S, Del Prete E, Vergallo A, Nuti A. Migraine features in migraineurs with and without anxietyâ€“depression symptoms: A hospital-based study. Clinical neurology and neurosurgery. 2015 May 31;132:74-8.
Yang M, Yang J, Zeng F, Liu P, Lai Z, Deng S, Fang L, Song W, Xie H, Liang F. Electroacupuncture stimulation at sub-specific acupoint and non-acupoint induced distinct brain glucose metabolism change in migraineurs: a PET-CT study. Journal of translational medicine. 2014 Dec 12;12(1):351.
Guldiken B, Guldiken S, Demir M, Turgut N, Tugrul A. Low leptin levels in migraine: a case control study. Headache: The Journal of Head and Face Pain. 2008 Jul 1;48(7):1103-7.
He-min Z, Guo-rong B, Qiu H, Xiang L, Suli L. Changes in plasma PPARs levels in migraine patients. Medical Science Monitor. 2015 Mar 11;21:735-9.
Peterlin BL. The role of the adipocytokines adiponectin and leptin in migraine. J Am Osteopath Assoc. 2009 Jun 1;109(6):314-7.
Paganelli R, Di Iorio A, Patricelli L, Ripani F, Sparvieri E, Faricelli R, Iarlori C, Porreca E, Di Gioacchino M, Abate G. Proinflammatory cytokines in sera of elderly patients with dementia: levels in vascular injury are higher than those of mildâ€“moderate Alzheimer's disease patients. Experimental gerontology. 2002 Jan 3;37(2):257-63.
Fillit H, Ding W, Buee L, Kalman J, Altstiel L, Lawlor B, Wolf-Klein G. Elevated circulating tumor necrosis factor levels in Alzheimer's disease. Neuroscience letters. 1991 Aug 19;129(2):318-20.
Perini F, Dâ€™Andrea G, Galloni E, Pignatelli F, Billo G, Alba S,Bussone G, Toso V Plasma cytokine levels in migraineurs and controls. Headache 2005 45:926â€“931
Headache classification committee of the International Headache Society. Cephalalgia,2004,suppl 1, 1-160
Thurstone,L.L and Mellinger, J.J., The stroop test, Psychometric laboratory report No.3, May; 1953
Winter AC, Berger K, Buring JE, Kurth T. Body mass index, migraine, migraine frequency and migraine features in women. Cephalalgia. 2009 Feb 1;29(2):269-78.
Winter AC, Wang L, Buring JE, Sesso HD, Kurth T. Migraine, weight gain and the risk of becoming overweight and obese: a prospective cohort study. Cephalalgia 2012 32:963â€“971
Ornello R, Ripa P, Pistoia F, Degan D, Tiseo C, Carolei A, Sacco S. Migraine and body mass index categories: a systematic review and meta-analysis of observational studies. The journal of headache and pain. 2015 Mar 28;16(1):27.
Bigal ME, Lipton RB, Holland PR, Goadsby PJ. Obesity, migraine, and chronic migraine Possible mechanisms of interaction. Neurology. 2007 May 22;68(21):1851-61.
Bond DS, Roth J, Nash JM, Wing RR. Migraine and obesity: epidemiology, possible mechanisms and the potential role of weight loss treatment. Obesity Reviews. 2011 May 1;12(5):e362-71.
Sarchielli P, Alberti A, Baldi A, Coppola F, Rossi C, Pierguidi L, Floridi A, Calabresi P. Proinflammatory cytokines, adhesion molecules, and lymphocyte integrin expression in the internal jugular blood of migraine patients without aura assessed ictally. Headache: The Journal of Head and Face Pain. 2006 Feb 1;46(2):200-7.
Beattie EC, Stellwagen D, Morishita W, Bresnahan JC, Ha BK, Von Zastrow M, Beattie MS, Malenka RC. Control of synaptic strength by glial TNFÎ±. Science. 2002 Mar 22;295(5563):2282-5.
Ãlvarez A, Cacabelos R, Sanpedro C, GarcÃa-Fantini M, Aleixandre M. Serum TNF-alpha levels are increased and correlate negatively with free IGF-I in Alzheimer disease. Neurobiology of aging. 2007 Apr 30;28(4):533-6.
Dik MG, Jonker C, Hack CE, Smit JH, Comijs HC, Eikelenboom P. Serum inflammatory proteins and cognitive decline in older persons. Neurology. 2005 Apr 26;64(8):1371-7.
Pickering M, Oâ€™Connor JJ. Pro-inflammatory cytokines and their effects in the dentate gyrus. Progress in brain research. 2007 Dec 31;163:339-54.
Viviani B, Gardoni F, Marinovich M. Cytokines and neuronal ion channels in health and disease. International review of neurobiology. 2007 Dec 31;82:247-63.
Gemma C, Catlow B, Cole M, Hudson C, Samec A, Shah N, Vila J, Bachstetter A, Bickford PC. Early inhibition of TNFÎ± increases 6-hydroxydopamine-induced striatal degeneration. Brain research. 2007 May 25;1147:240-7.
Godbout JP, Johnson RW. Interleukin-6 in the aging brain. Journal of neuroimmunology. 2004 Feb 29;147(1):141-4.
Fiore M, Angelucci F, Alleva E, Branchi I, Probert L, Aloe L. Learning performances, brain NGF distribution and NPY levels in transgenic mice expressing TNF-alpha. Behavioural brain research. 2000 Jul 31;112(1):165-75.
Capsoni S, Cattaneo A. On the molecular basis linking nerve growth factor (NGF) to Alzheimerâ€™s disease. Cellular and molecular neurobiology. 2006 Jul 1;26(4-6):617-31.
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