Migraine Brain Drain: The Cognitive Effects of Attacks

January 24, 2018

Thinking Through Pain

As most anyone with migraine can tell you, attacks are incredibly disruptive and difficult to manage. Depending on the case, migraineurs face crippling, debilitating headaches, severe nausea, increased and uncomfortable sensitivity to certain stimuli, dizziness, and lack of energy among others. And there’s no doubt that when this condition fully presents, it tends to take over.

Given how debilitating migraine is—and how much work is still needed in understanding it—it’s no surprise that some researchers have looked into how attacks affect cognition skills. These are the upper-level processing tasks that the brain engages in when doing things like reading, processing stimuli, using verbal memory, and learning, among others. While there is more work to be done, a sense of how cognition is affected by migraine has been emerging.

Distinct Effects for Non-Aura Migraines

Seeing a lack of definitive research surrounding the effects of migraine on upper-level cognitive tasks, a team of researchers from the University of Lisbon, Portugal under the direction of Dr. Raquel Gil-Gouveia decided to take on the issue head on. They recruited 39 episodic migraineurs and tested them on a variety or cognitive tasks during attacks and during normal conditions.

As reported in the journal, Cephalalgia, in 2014, Dr. Gil-Gouveia and the team focused on quite a few cognitive tasks and found distinct effects in almost all of them. Most notably, were differences observed in “word-reading speed,” “verbal learning,” “short-term verbal recall,” and “delayed recall without semantic cues” when people were experiencing attacks. [1] Further, they found that other factors like the participant’s age, gender, established reading skills, level of anxiety, degree of pain, and length of attack were not influential here.

Clearly, attacks were indeed affecting cognitive function, which, for the authors, suggested “a reversible brain dysfunction during attacks of migraine without aura, which can relate specifically to migraine or be a consequence of acute pain processing by the brain.” [1] Noting a need for more research on this, they hold that it’s not entirely clear whether migraine itself influences cognition, or if it’s the resultant pain that’s at the root.

A Broader Effect

In a more recent study, published in The Journal of Headache and Pain in 2016, Drs. Gabriella Santangelo and Antonio Russo, along with a team of colleagues, wanted to a get wider view of this relationship. They recruited 72 non-aura migraineurs of varying levels—both chronic and episodic sufferers—as well as 72 “healthy” individuals for comparison. Participants were to abstain from migraine management treatments or drugs for three days around testing. [2]

After recording the migraine history and intensity of the patient population, all subjects were evaluated on a range of cognitive tasks, with migraineurs tested both during attack periods and when not feeling symptoms. Specifically assessed were abilities in attention, memory, language, visuospatial processing (ability to see and perceive the world) and executive functions (mental control and self-regulations).

In line with previous work, migraine attacks were found to impede most cognitive abilities, specifically those in the “executive function, attention, visuospatial and memory domains.” [2] As with Dr. Gil-Gouveia’s study, factors like frequency of migraine and duration of attacks did not seem to influence this effect. Largely, too, the effects were found to be relatively mild; however, Drs. Santangelo and Russo believe that an understanding of the types of dysfunctions occurring here can help researchers better understand disease and further improve treatment.

The Step Forward

Clearly, migraine is more than “just” a headache; it’s a complicated condition that seriously impacts the lives of those with it. But, it’s important to remember that treatments are out there and getting better all of the time. For the migraineur, it’s important not to give up: some treatment or intervention will work. Despite the tough days or weeks, the picture is getting brighter.

If you suffer from chronic migraine, the experts at Migraine Treatment Centers of America are ready to help. Employing the latest in technologies and techniques, the team here has helped countless migraineurs manage their condition. Call a Patient Care Manager there today at (855) 300-6822.  


  1. “Cognitive Dysfunction During Migraine Attacks: A Study On Migraine Without Auracephalalgia – Raquel Gil-Gouveia, António G Oliveira, Isabel Pavão Martins, 2015”. 2017. Cephalalgia. http://journals.sagepub.com/doi/abs/10.
  2. Santangelo, Gabriella, Antonio Russo, Luigi Trojano, Fabrizia Falco, Laura Marcuccio, Mattia Siciliano. Francesca Conte, Federica Garramone, Alessandro Tessitore, and Gioacchino Tedeschi. “Cognitive Dysfunctions And Psychological Symptoms In Migraine Without Aura: A Cross-Sectional Study”. The Journal Of Headache And Pain17 (1). Springer Nature. doi:10.1186/s10194-016-0667-0.

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