title: Cognitive dysfunctions and psychological symptoms in migraine without aura: a cross-sectional study.
abstract: BACKGROUND
  The occurrence of cognitive dysfunctions and psychological symptoms, as well as their mutual relationships, in migraine patients are still debated. The aim of the study was to characterize the cognitive profile and psychological symptoms (i.e. depression, anxiety and apathy) in drug-naïve migraine without aura (MwoA) patients.
  
  
  METHODS
  Seventy-two consecutive MwoA patients, referred to the Italian University Headache Clinic and 72 healthy subjects (HCs) were enrolled. Patients, during an attack-free period, and HCs completed Montreal Cognitive Assessment (MoCA), Beck Depression Inventory-II (BDI-II), Self-version of Apathy Evaluation Scale (AES-S) and State and Trait Anxiety Inventory (STAI-Y-1 and 2). Clinical parameters of disease severity (i.e. disease duration, migraine attacks per month, mean pain intensity during migraine attacks, migraine disability and impact on daily life) were recorded.
  
  
  RESULTS
  Although performance of MwoA patients on MoCA was above Italian cut-off threshold (<15.5) suggesting presence of cognitive impairment, MwoA patients achieved significantly lower scores than HCs on total MoCA scale (22.3 ± 2.7 versus 25.4 ± 2.3) and on its attention (4.9 ± 1.1 versus 5.6 ± 0.7), memory (1.8 ± 1.4 versus 3.1 ± 1.3), visuospatial (3.2 ± 0.9 versus 3.6 ± 0.6) and executive subscales (2.6 ± 1.1 versus 3.1 ± 0.8). In addition, we observed significant correlations between MoCA executive domain subscore and the attack-related disability score (MIDAS). As for behavioral profile, the percentage of depressive symptoms (4.2 %), high state and trait anxiety (13.9 and 9.7 %, respectively), and apathy (11.1 %) in MwoA patients were similar to that of HCs. No significant associations of behavioural symptoms with cognitive performance and clinical parameters were found.
  
  
  CONCLUSIONS
  Drug-naïve MwoA patients are characterized by subtle cognitive dysfunctions and low percentage of behavioural symptoms. The results support the importance of searching for subclinical cognitive disturbances in patients with MwoA, who deserve to be followed-up to verify whether they develop clinically relevant disorders over time.
authors: Department of Psychology, Second University of Naples, Caserta, 81100, Italy.|Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, 80100, Italy.
authors: Gabriella
authors: G
authors: Santangelo
authors: Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy.|Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, 80100, Italy.
authors: Antonio
authors: A
authors: Russo
authors: Department of Psychology, Second University of Naples, Caserta, 81100, Italy. luigi.trojano@unina2.it.|Salvatore Maugeri Foundation, Scientific Institute of Telese, Telese Terme, BN, 82037, Italy. luigi.trojano@unina2.it.
authors: Luigi
authors: L
authors: Trojano
authors: Department of Psychology, Second University of Naples, Caserta, 81100, Italy.
authors: Fabrizia
authors: F
authors: Falco
authors: Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy.|Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, 80100, Italy.
authors: Laura
authors: L
authors: Marcuccio
authors: Department of Psychology, Second University of Naples, Caserta, 81100, Italy.|Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, 80100, Italy.
authors: Mattia
authors: M
authors: Siciliano
authors: Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy.|Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, 80100, Italy.
authors: Francesca
authors: F
authors: Conte
authors: Department of Psychology, Second University of Naples, Caserta, 81100, Italy.
authors: Federica
authors: F
authors: Garramone
authors: Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy.|Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, 80100, Italy.
authors: Alessandro
authors: A
authors: Tessitore
authors: Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy. gioacchino.tedeschi@unina2.it.|Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, 80100, Italy. gioacchino.tedeschi@unina2.it.
authors: Gioacchino
authors: G
authors: Tedeschi
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020326:Migraine without Aura / Q000453:epidemiology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales
keywords: Apathy; Cognitive deficits; Depression; Migraine; MoCA; Montreal cognitive assessment