Prospective evaluation of prodrom findings in migraine patients with and without aura

Introduction: Migraine is important due to its widespread occurrence at a young age, it causes significant disability in individuals, and it effects on cognitive functions. In this thesis study, we prospectively evaluated cognitive functions using various cognitive tests during the prodromal and interictal periods. We assessed patients on the day they visited the clinic without pain, and contacted them 72 hours later to inquire whether they had experienced a migraine attack during this period. If the patient experienced a migraine headache within 72 hours, we considered these patients to be in the prodrome period. If they did not experience a headache within 72 hours, we considered these patients to be in the interictal period. Patients in the prodrome and interictal periods were compared in terms of cognitive tests. Method: After obtaining ethical approval, 178 migraine patients were included in the study based on inclusion and exclusion criteria. We thoroughly questioned the demographic characteristics, habits, and headache features of the patients. We evaluated the disability due to migraine using MIDAS and the severity of headache using the Visual Analog Scale (VAS). Beck Depression and Anxiety scales were administered for mood assessment. To evaluate cognitive functions, we applied the Stroop, Frontal Assessment Battery (FAB), and Clock Drawing Test (CDT). Results: When cognitive test results of 100 patients in the prodromal period and 78 patients in the interictal period were compared, patients in the prodromal period performed worse in all three tests. Patients in the prodromal period had higher scores on the Beck Anxiety scale and MIDAS total scores compared to those in the interictal period. While we detected a significant relationship between MIDAS and CDT, we did not detect a significant relationship between MIDAS and other cognitive tests. Additionally, as MIDAS scores increased, patients' total scores on Beck Anxiety and Depression scales also increased. Patients with autonomic involvement had higher total scores on the Beck Anxiety scale. Conclusion: This study aims to demonstrate that cognitive dysfunction observed during the ictal phase in migraine patients begins in the prodromal period. Understanding the prodromal period and cognitive dysfunction may shed light on new treatments that will have an impact before the attack and reduce migraine-related disability. KEYWORDS: Migraine, Prodrome, Cognitive impairment, Stroop, Frontal Assessment Battery