Evaluation of cognition in the patients with diagnosis of tension-TYPE headaches

Introduction: Tension-type headache (TTH) is a type of headaches that is common in the population. Based on ICHD-3 criteria, it is divided in four groups as infrequent episodic, frequent episodic, chronic, and probable TTH. The present study aimed at comparing cognitive function, personality traits, and quality of life between the patients diagnosed as having TTH and the control group without any primary or secondary type of headaches. Methods: A total of 50 subjects with equal number of the males and females presenting to outpatient clinic of headaches of Neurology Department of Medical Faculty of Celal Bayar University with diagnosis of TTH were evaluated prospectively based on the inclusion and exclusion criteria following approval from the Ethics Committee. Demographic characteristics, habits, features of the headaches were queried in detail. A control group of subjects without primary/secondary type of headaches with the equal number of individuals and the same age range was included in the study. Visual Analog Scale (VAS) was used to query severity of the headaches. MOCA, Stroop, Frontal Assessment Battery (FAB), Visual-Auditory Number Array (VANA-B), and clock drawing tests were applied to evaluate cognitive function of the subjects. Beck's Anxiety Scale and Beck's Depression Scale were used to evaluate anxiety level of the subjects. Lawton-Brody Instrumental Activities of Daily Living Scale and Short Form 36 (SF-36) were used to evaluate daily living activities and quality of life, respectively. Revised short version of Eysenck personality questionnary was used to evaluate personality domains of the subjects. Findings: According to results of the tests and questionnaris, scores on the attention and delayed memory sub-scales and total score of MOCA were found to be significantly lower in the subjects with diagnosis of TTH. Longer times (poorer outcomes) were found on the scores on the Parts 4 and 5 of Stroop test, Stroop difference (B5-b1) and total score of Stroop test. No statistically significant difference was found in results of FAB test between two groups. Scores of auditory verbal, visual verbal, visual stimulatory, auditory stimulatory, written expression, verbal expression, sensual fusion, between-senses fusion and total score of VANA were found to be significantly lower in the group of patients. Both groups of subjects and controls achieved full points on the test of clock drawing and daily living activities questionnaire and no statistically significant difference was found. Scores on the depression and anxiety scales were found to be significantly higher in the group of patients than controls. It was also found that neuroticism scores based on Eysenck Personality Questionnaire were significantly higher in the group of patients. When the group of patients and controls were compared for quality of life, it was found that physical function, physical role difficulty, emotional role difficulty, energy/vitality, psychological health status, social functioning, pain and general health perception were found to be lower in the group of patients. Conclusion:In the present study, it was aimed to evaluate cognitive function, personality traits, and quality of life together in the patients with diagnosis of TTH. It was seen that the patient with TTH and especially in those with myofascial pain had decreased cognitive function and quality of life. This decrease was seen to be impacted by psychopathological conditions such as depression and anxiety but it was seen that lower scores were achieved by the patients than the controls in cognitive function and quality of life independent of the depression and anxiety. Currently, there is no study in the literature evaluating cognitive function, personality traits, and quality of life concurrently in TTH. Thus, we consider that our study contributes to the literature