People who have frequent migraine or other severe headaches can be reassured that they are not at increased risk of cognitive decline, even though they are much more likely than non-sufferers to have microvascular brain lesions, report researchers on bmj.com.
Earlier studies using MRI had shown that migraine sufferers were more likely than non-sufferers to have lesions of their brain microvessels – white matter hyperintensities or, less commonly, silent infarcts. White matter hyperintensities, if present in large quantities, raise the risk of cognitive deterioration, stroke, dementia, depression and movement disorders.
Because of this, researchers wanted to know whether migraine could affect cognitive function in the long term. So, in the Epidemiology of Vascular Ageing-MRI study, they performed a cerebral MRI on more than 800 people aged 65 years or older, drawn from the general population in Nantes, France. Participants were questioned about their history of headaches by a neurologist and monitored for 10 years.
The study authors evaluated subjects’ short-term memory, orientation in time and space, and ability to quickly and correctly carry out designated tasks. Lifetime prevalence of severe headaches was 21%, and in 70% of cases included migraines (migraine with aura was reported by 2% of all participants).
Sufferers of severe headaches of any type were twice as likely as people without headaches to have a higher volume of white matter hyperintensities shown on MRI.
However, people with severe headaches had identical cognitive scores to those without headaches – whether or not MRI had shown microvascular lesions. Migraine with aura was associated with an increased risk of silent cerebral infarcts but, again, not with any detectable cognitive deficit.
The authors conclude: “This is a very reassuring result for the many people who suffer from migraine. In spite of the increased presence of lesions of the brain microvessels, this disorder does not increase the risk of cognitive decline. […] Therefore, we have not observed negative consequences of migraine on the brain.”