Brain & Nervous System Migraines Living With Are Migraines Associated With Cognitive Problems? By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Colleen Doherty, MD Medically reviewed by Medically reviewed by Nicholas R. Metrus, MD on January 16, 2020 linkedin Nicholas R. Metrus, MD, is board-certified in neurology and neuro-oncology. He currently works at the Glasser Brain Tumor Center with Atlantic Health System in Summit, New Jersey. Learn about our Medical Review Board Nicholas R. Metrus, MD on January 16, 2020 Print Aside from the short-term, albeit debilitating pain and "brain fog" associated with a migraine attack, researchers are finding that migraines may also be associated with cognitive problems in between migraine attacks. Your cognitive abilities refer to mental processes your brain performs in order to acquire information, and then understand, communicate, process, judge, and remember that information. Your cognitive abilities are important because they affect your actions, and how you interact with others and your environment—they are part of your identity, so to speak. Therefore, the idea that migraines may affect your cognition, even outside of an attack, is understandably unsettling. Let's take a closer look at the potential migraine/cognition association, and what this may mean for you or your loved one. The Migraine and Cognition Association To understand the association between migraines and cognitive problems, you have to start with the notion that migraines may affect brain structure, which then may affect brain function. Brain Structure Various neuroimaging techniques, such as magnetic resonance imaging (MRI) and more advanced tools, like voxel-based morphometry (VBM), have found that migrauneurs have an increased prevalence of structural brain alternations. Some of these structural brain findings include: increased iron depositionincreased deep white matter lesions and strokesreduced white matter and grey matter density Researchers have found that structural brain differences correlate with a higher migraine headache frequency and longer disease duration. This correlation further supports the idea that these structural brain changes are secondary to migraine and not some other factor. Of course, the question remains, whether these brain differences actually affect brain function. Brain Function One study examined the grey matter density (using both MRI and VBM) in 25 adults participants with migraines to 25 control participants (people of the same age and gender, but without migraine). The researchers found that compared to the control group, the migraineurs had a slower response time to task set-shifting (an executive function), and this slower response time correlated to a reduced grey matter density in the frontal lobe of the migrauners. Another study examined 34 migraineurs and found that compared to healthy control subjects, the migraineurs performed worse on the Montreal Cognitive Assessment (MoCA), which is a screening test of general cognitive abilities. More specifically, migraineurs performed worse in the following cognitive areas: languagememoryexecutive functionscalculationorientation In addition, the study investigators found that a decrease in the overall MoCA score was linked to the duration of migraine (meaning the longer their migraine attacks generally last, the lower their overall score). Likewise, a decrease in the executive function score part of the MoCA was linked to the frequency of migraine (meaning the more migraine attacks they have per month, the lower the executive function score). Opposite Findings It's important to keep in mind that some studies have found no cognitive performance issues with migrainuers. In fact, one study in the European Journal of Neurology found improved cognitive performance in migraineurs versus non-migraineurs. In this study, migraineurs, especially those with aura, had higher average mini-mental status examination scores and performed better on tests of executive function. While any differences in findings may be explained by study design and methods used to access cognition, this study (and the ones that found no link) do imply that more investigation needs to be done into this potential association. Conclusion Even if a link exists between migraine and cognitive problems, we don't know the extent of that link, meaning how noticeable or life-altering those cognitive changes are. The bottom line here is that emerging research tends to support a link between migraine and cognitive impairment—however, it simply hasn't all been teased out yet. What This Means for You Until the migraine/cognition association is sorted out, try not to worry too much about it. It's better, instead, to focus on things you can control, like various ways you can prevent migraines from occurring. For instance, here are few proactive ways to thwart off a migraine: Avoid/minimize your unique triggers (for example, bright lights, certain odors, or foods such as processed meats, aged cheese, and foods containing MSG)Maintain a regular sleep schedule, even on the weekendsMinimize stress—consider trying mindfulness meditation or yoga to help you relaxModerate your caffeine and alcohol intake It's also sensible to talk with your doctor about whether or not you are a candidate for a migraine preventive medication. While it's unknown whether preventive drugs can reverse any migraine-related cognitive dysfunction, a preventive drug can reduce the number and severity of your migraine attacks. A Word From Verywell Migraine is a brain disease, so with that comes concern about the effects on the brain, like cognition. Of course, if you are worried about cognitive changes, whether or not you suffer from migraines, please speak to your doctor. Your doctor may perform a couple of simple in-office tests or refer you for formal cognitive testing with a neuropsychologist. Migraines and Depression: Their Link and How to Manage Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Huang L, Dong HJ, Wang X, Wang Y, Xiao Z. Duration and frequency of migraines affect cognitive function: evidence from neuropsychological ests and event-related potentials. 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