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Deciphering the mechanisms: pathophysiology of migraine-related cognitive dysfunction

2025-09-01Artigo de revisão Acesso aberto
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dc.contributor.authorFernandes, Catarina
dc.contributor.authorGil-Gouveia, Raquel
dc.date.accessioned2025-10-01T13:42:43Z
dc.date.available2025-10-01T13:42:43Z
dc.date.issued2025-09-01
dc.description.abstractMigraine is increasingly understood as a disorder of brain network dysfunction, where attack-related cognitive symptoms (attention deficits, slowed processing speed and executive dysfunction) can be as disabling as pain and may persist into the interictal period. Such symptoms are associated with functional and structural changes across the migraine cycle, involving the prefrontal cortex, thalamus, hypothalamus, hippocampus and cerebellum. Interictal deficits in working memory, visuospatial processing, verbal fluency and executive function are also documented. Rodent models show impairments in learning and memory, while humans studies suggest that cortical hyperresponsiveness and deficient sensory habituation contribute to altered attentional processing, reflecting thalamocortical dysfunction and abnormal synaptic plasticity as underlying mechanisms. Cognitive performance is modulated by disease severity, chronification, hormonal fluctuations, psychiatric comorbidities, sleep disturbances and medication use. Anxiety, depression and sleep disorders negatively affect working memory, executive function and attention, while medication overuse further impairs visuospatial skills and orientation. Dementia risk appears heightened in migraine patients with frequent and severe attacks, as clinic-based studies consistently report cognitive deficits in this cohorts, unlike population-based studies. While longitudinal cohorts find no increased dementia risk, meta-analyses suggest a modest risk elevation. Differences are likely due to methodological differences in cognitive testing and diagnostic approaches. Cognitive dysfunction in migraine is multidimensional, involving intrinsic neuronal mechanism and external modulators, supporting the need for rational management strategies and treatment interventions.eng
dc.identifier.citationFernandes, C., & Gil-Gouveia, R. (2025). Deciphering the mechanisms: pathophysiology of migraine-related cognitive dysfunction. Cephalalgia : an international journal of headache, 45(9). https://doi.org/10.1177/03331024251368328
dc.identifier.doi10.1177/03331024251368328
dc.identifier.eid105015795942
dc.identifier.issn0333-1024
dc.identifier.othera060264b-95ae-45b6-89f1-d98c3d058a98
dc.identifier.pmid40936446
dc.identifier.urihttp://hdl.handle.net/10400.14/55106
dc.identifier.wos001585860600002
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectCognition
dc.subjectCognitive impairment
dc.subjectFunctional brain imaging
dc.subjectHeadache
dc.subjectMigraine
dc.subjectNeurophysiology
dc.subjectNeuropsychology
dc.titleDeciphering the mechanisms: pathophysiology of migraine-related cognitive dysfunctioneng
dc.typereview article
dspace.entity.typePublication
oaire.citation.issue9
oaire.citation.titleCephalalgia : an international journal of headache
oaire.citation.volume45
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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