While migraines are primarily known for their physical effects, they can also have significant cognitive effects that can impact a person’s ability to think, work, and perform everyday activities. In young and middle-aged adults, migraines have been associated with deficits in attention, executive function, processing speed, and memory.
Neuroimaging studies have provided evidence for structural brain alterations in migraine sufferers, which are associated with higher migraine headache frequency and longer disease duration. Furthermore, cognitive assessments have shown that migraine sufferers perform poorly in several cognitive domains, particularly executive function.
Executive functioning refers to a set of cognitive processes that are responsible for planning, organizing, and executing complex tasks. People with migraines may experience difficulties with executive functioning before, during, and after an attack, which can impact their ability to perform complex tasks such as driving or operating machinery. This can also impact their ability to manage their daily lives, including tasks like paying bills, managing schedules, and completing household chores.
Many migraine sufferers report experiencing “brain fog” up to 48 hours before and 24 hours after an attack. Patients report that brain fog makes it hard to focus and find the right words. They may feel distracted, forgetful, or less alert or have trouble completing simple tasks.
While more research is needed in this area, it’s believed that brain fog is linked to cortical depression in the brain leading up to a migraine attack. Cortical depression is an electrical and blood flow process that often spreads from the back of the brain (where vision is controlled) to the front of the brain (where thinking is controlled).
Typically, the cognitive dysfunction occurs when you have a headache and not at other times. There is conflicting research about the effect of migraines on patients’ risk of cognitive issues later in life, specifically in developing dementia. One recent study found that migraine is associated with an increased risk of all-cause dementia, vascular dementia, and Alzheimer’s disease, but earlier studies found no link between the two.
Cognitive symptoms, like those discussed here, can serve as an early warning sign of an oncoming attack. Noticing these symptoms gives sufferers time to prepare and treat the attack while the pain is mild.
At The Will Erwin Headache Research Foundation, we’re dedicated to supporting headache sufferers and providing accurate and accessible information about the effects of debilitating headaches. Ultimately, we aim to cure debilitating headaches, like migraine. If you’re interested in supporting our mission, consider donating today.