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ARTICLES: A. Kalaydjian, P. P. Zandi, K. L. Swartz, W. W. Eaton, and C. Lyketsos How migraines impact cognitive function: Findings from the Baltimore ECA Neurology 2007; 68: 1417-1424 [Abstract] [Full text] [PDF]

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How migraines impact cognitive function: Findings from the Baltimore ECA

Salvador Vale   (24 May 2007)

How migraines impact cognitive function: Findings from the Baltimore ECA 24 May 2007
Salvador Vale, Researcher Tlaxcala 90, 1er piso, Col Roma, Mexico DF Send Correspondence to journal: Re: How migraines impact cognitive function: Findings from the Baltimore ECA svalemayorga{at}yahoo.com.mx Salvador Vale	Kalaydjian et al show that migraineurs, specifically those with aura, exhibited less decline on cognitive tests over time as compared to nonmigraineurs.[1] They conclude "...there may be some underlying biologic mechanism associated with migraine headaches, such as changes in vasculature or underlying differences in neuronal activation, which results in decreased cognitive decline over time.” In this regard, clinical evidence points to involvement of dopamine in both the pathophysiology of migraine and in the improvement of age-related cognitive deficiencies. On one hand, the dopamine receptor antagonist domperidone taken during the premonitory phase can prevent the occurrence of migraine. Also, an increased frequency of dopamine beta-hydroxylase activity is present both during and between the headache phases of the migraine attack.[2] Moreover, migraine prevalence is lower in patients with deficient dopamine activity like in Parkinson disease (PD). [3] However, prefrontal cortical dopamine regulates various executive cognitive functions including attention and working memory. A recent report shows enhancement of prefrontal cortical function and improved cognition in normal human individuals with tolcapone, a nonstimulant drug with Catechol-O-Methyl-Transferase inhibitory activity which increases prefrontal dopamine preferentially. [4] A dementia-retarding effect with amantadine, a dopamine agonist, has been shown in patients with PD. [5] It is possible that the increase in dopamine activity underlying the pathophysiology of some type of migraines can also be responsible for better cognitive preservation during aging. This suggestion may be an important strategy in the prevention of age-related cognitive deficiencies. References 1. Kalaydjian A, Zandi PP, Swartz KL, et al. How migraines impact cognitive function: Findings from the Baltimore ECA. Neurol 2007;68: 1417-1424. 2. Bergerot A, Storer RJ, Goadsby PJ. Dopamine inhibits trigeminovascular transmission in the rat. Ann Neurol 2007;61:251-262. 3. Barbanti P, Fabbrini G, Vanacore N, et al. Dopamine and migraine: does Parkinson’s disease modify migraine course? Cephalalgia 2000;20:720–723. 4. Apud JA, Mattay V, Chen J, et al. Tolcapone improves cognition and cortical information processing in normal human subjects. Neuropsychopharmacology 2007;32:1011-1020. 5. Inzelberg R, Bonuccelli U, Schechtman E, et al. Association between amantadine and the onset of dementia in Parkinson's disease. Mov Disord. 2006;21:1375-1379. Disclosure: The author reports no conflicts of interest. The authors were offered the opportunity to respond but declined.