Memory and Cognitive Effects of Cluster Headaches
Curr Pain Headache Rep. 2005 Apr;9(2):109-12.
Cognitive processing in cluster headache.
Evers S.
Department of Neurology, University of Munster, Albert-Schweitzer-Str. 33, 48129
Munster, Germany. everss@uni-muenster.de.
Little is known about specific changes of cognitive processing in cluster
headache. Studies on event-related potentials (ERP) suggest that stimulus
evaluation is impaired in chronic cluster headache and in episodic cluster
headache during the cluster period, but not in the interval between two periods.
Patients with chronic paroxysmal hemicrania do not show this impairment. Unlike
patients with migraine, patients with cluster headache do not present with a
loss of cognitive habituation as measured by ERP. In neuropsychologic
evaluations, a reversible decline of memory processing was detected during the
cluster attack, but not between two attacks. Long-term observation revealed no
progressive cognitive decline in cluster headache patients over the years. With
regard to personality changes, a liability susceptibility to anxiety disorders
and to hypochondriasis, but not to mood changes, has been described
inconsistently. All changes in alterations of cognitive processing in cluster
headache are demonstrated to be mild and do not relevantly contribute to the
clinical picture of this disease.
Publication Types:
Review
PMID: 15745620
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Headache. 2000 Sep;40(8):638-46.
Reversible cognitive decline accompanies migraine and cluster headaches.
Meyer JS, Thornby J, Crawford K, Rauch GM.
Cerebrovascular Research, Baylor College of Medicine, Houston, TX, USA.
Vascular headaches, including migraine, cluster, and migrainous transformation to chronic daily headaches, are disabling. During and shortly after headache intervals, difficulties are reported in concentration, comprehension, and communication, not accounted for by nausea, photophobia, or sonophobia. These interfere with interpersonal relations and performance at work with economic loss. The hypothesis tested and reported here is that cognitive impairments comprise an important part of vascular headache diatheses. One hundred ninety-six otherwise normative subjects suffering from migraine or cluster, but not tension-type, headaches (136 women, 63 men; mean age, 46 years) participated in an outpatient prospective trial. One hundred thirty-three patients had migraine without aura, 39 migraine with aura, 11 periodic cluster (by IHS criteria), and 13 had migrainous transformation into chronic daily headaches. Neuropsychological testing was compared with and without headaches, by combined Mini-Mental Status Examination (MMSE), Cognitive Capacity Screening Examination (CCSE), and Hamilton Depression Rating Scale (HDRS). During headache intervals, significant decline was measured in both CCSE and MMSE scores (P <. 001) without HDRS change in all types of vascular headache and independent of headache severity, which often improved, or associated physical symptoms. Cognitive decline was promptly relieved by serotonin agonists and sleep. Disorders of cerebral serotoninergic projection systems appear to cause these reversible cognitive impairments.
PMID: 10971660
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Neurology. 1999 Aug 11;53(3):543-7.
Cluster headaches: association with anxiety disorders and memory deficits.
Jorge RE, Leston JE, Arndt S, Robinson RG.
Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City 52242-1057, USA.
OBJECTIVE: To estimate the frequency of mood and anxiety disorders and to assess memory and executive functions among a representative group of patients with episodic cluster headache (ECH) during the course of an acute episode.
METHODS: We compared 21 patients with ECH with 21 patients with tension headache (TH) matched for age, sex, and educational level. Psychiatric diagnosis was made by a semi-structured interview and Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria. Quantitative measures of depression and anxiety were obtained using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale (HARS). In addition, all patients received a neuropsychological evaluation to assess basic memory and executive functions.
RESULTS: Of the 21 patients with ECH, 5 (24%) met DSM-IV criteria for an anxiety disorder during the year before the episode. Panic disorder was diagnosed in two patients (10%). The remaining three patients (14%) met criteria for generalized anxiety disorder. Of the 21 patients with TH, 2 (10%) met diagnostic criteria for an adjustment disorder with depressed mood, and 1 (5%) met criteria for an adjustment disorder with mixed anxiety and depressed mood. HARS scores were higher among patients with ECH (Kruskal-Wallis, chi2 = 4.3, df = 1, p = 0.03). ECH patients also showed significantly lower Auditory Verbal Learning Test scores (Kruskal-Wallis, chi2 = 6.5, df = 1, p = 0.01).
CONCLUSIONS: When compared with a group of patients with TH, ECH patients showed a higher frequency of anxiety disorders during the year before the onset of headaches and significantly greater HARS scores during the episode. In addition, patients with ECH were selectively impaired in verbal memory.
PMID: 10449118
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