Headache and cognitive profile in children a cros

Authors: Pasquale Parisi Alberto Verrotti Maria Chiara Paolino Antonella Urbano Mariangela Bernabucci Rosa Castaldo Maria Pia Villa

Publish Date: 2010/02

Volume: 11, Issue: 1, Pages: 45-

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Abstract

We investigated whether children affected by tensiontype headache and migraine without aura compared with a healthy control group that was matched by age culturally and socioeconomically display a diverse intellectual functioning and have a separate “cognitive profile” A crosssectional study was conducted from January 2006 to November 2008 at “Sapienza University” in Rome A total of 134 children were diagnosed as being affected by either migraine without aura 93 or tensiontype headache 41 On the basis of our exclusion/inclusion criteria we enrolled 82 of these 134 children 63 of whom were affected by migraine without aura and 19 by tensiontype headache On entry cognitive functions were assessed in both the affected subjects and the control group by the Wechsler Intelligence Scale for Childrenrevised Significant differences were found between the headache and control groups in the mean total intelligence quotient and verbal intelligence quotient scores p  0001 Significant negative correlations were found between the total intelligence quotient verbal intelligence quotient performance intelligence quotient and the frequency of attacks r = −055 and p  0001 r = −061 and p  0001 r = −029 and p  001 respectively as well as between the total intelligence quotient score and the age at headache onset r = 0234 p  005 Our results suggest that the cognitive profile of children affected by headache should be assessed at the first child neurology outpatient observation From a therapeutic point of view although within a normal range the abilities most likely to be less brilliant in such children are verbal skillsHeadache is a common disorder largely diffuse in childhood and adolescence The revised pediatric classification criteria introduced by the International Headache Society in 2004 1 2 have led to a more accurate definition of the various forms of headache in childhood and have resulted in a more careful differential diagnosis between migraine with MA and without aura MoA and tensiontype headache TTHIn brief the few studies available on cognitive dysfunction in pediatric headache have yielded contrasting results These discrepancies may be due to various reasons including the fact that a migrainefree control group was not used the nature of the neuropsychological tests administered was too broad or only a highly specific cognitive function was investigated 12 14 17 20 21In view of these contrasting findings and the lack of data in adult and particularly in the developmental age we decided to investigate by administering the Wechsler Intelligence Scale for Childrenrevised WISCR in a crosssectional controlled study whether children affected by either MoA or TTH who had never taken antimigraine therapy exhibited different intellectual functioning when compared with a headachefree control group that was matched by age culturally and socioeconomically WISCR is one of the tests used throughout the world to assess the global capacity of children between 6 and 16 years of age to act purposefully to think rationally and to deal effectively with their environment

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