Migraine and cognitive function

In 1982, Geschwind and Behan reported that migraineurs were more likely to be left-handed than were those without migraine, and they postulated that migraine might be a neurodevelopmental disorder.¹ While the cause of migraine remains obscure, recent clinical research has provided further evidence that the consequences of migraine may stretch beyond episodic symptoms to include structural and functional brain dysfunction. With the advent of MRI, apparently asymptomatic subcortical and deep white matter T2-weighted signal abnormalities in migraineurs were noted.² A methodologically robust cross-sectional study recently provided evidence that migraineurs, particularly those with aura, have an increased likelihood of MRI signal abnormalities in the cerebellar territory of the posterior circulation and, for women, in the deep white matter.³ Many investigators concluded that these signal abnormalities represent sequelae of ischemia. Migraineurs with aura, particularly women, may be at increased risk of ischemic stroke before the age of 45.^4,5 The connection between migraine and these clinical and subclinical brain lesions is uncertain, although the potential functional consequences are of considerable public health importance given …