A study that on the surface looks like great news for women living with migraine disease may not be quite as reassuring as it seems for a few among our ranks.
A research team at Brigham and Women’s Hospital in Boston used data from around 6,300 of the 40,000 women who participated in the Women’s Health Study. This smaller pool of women had provided information about their migraine status at the beginning of the Women’s Health Study and participated in cognitive testing during follow ups.
The study’s results look good for women living with migraine without aura and migraine with aura. These women are no more likely to experience substantial cognitive decline than women without any type of migraine disease.
Unfortunately, the news wasn’t as rosy for those women who have migraine with aura and have experienced a cardiovascular event (i.e. a heart attack or stroke). Women with migraine with aura who had experienced a cardiovascular event dealt with faster rates of cognitive decline than other women. This knowledge reinforces what we already know about the risks for women living with migraine with aura and comorbid cardiovascular conditions.
While this study is the best information we have on cognitive decline and migraine, it has some potential limitations:
- Self-reporting of migraine by patients, although the particular set of data used in this study has been shown to be quite accurate.
- No information about how long migraine patients had lived with attacks.
- Limited age range of study participants & other limited demographics, such as race, education and socioeconomic status.
- Quick follow up period by researchers between cognitive assessments.
I also wish the idea of using data from the Women’s Health Study to examine the relationship between migraine and cognitive decline had been in mind from the start of the study. Less than 6,500 of the 40,000 women in the Women’s Health Study provided information about whether they were migraine patients in the questionnaire they filled out at the beginning of the study. Had the idea for using the data this way been in mind from the beginning perhaps more women could have been included in this study.
While it would have been valuable to have a pool of women four or five times larger than the one the researchers had access to in this study, at least they used the data they did have available to help us learn more about migraine and its potential impact on cognition and cognitive decline.
This is by far the best study on this issue we have to date, despite its limitations, because it was prospective rather than cross sectional. In other words, it looked at the participants over a six year period of time, rather than at just one point in time, as many older studies did. Additionally, past studies were unable to separate out migraine without aura from migraine with aura to see if there were any difference in likelihood of cognitive decline between the two conditions, let alone within a subset of migraine with aura.
Questions about what this means for you or a loved one? Please share them in the comments section.
Sources: 1. Pamela M. Rist et al., “Migraine and cognitive decline among women: prospective cohort study,” BMJ 345 (2012): e5027, accessed August 15, 2012, doi: 10.1136/bmj.e5027. 2. “Good News: Migraines Hurt Your Head But Not Your Brain,” Brigham and Women’s Hospital press release, August 8, 2012, on the Brigham and Women’s Hospital web site, http://www.brighamandwomens.org/about_bwh/publicaffairs/news/pressreleases/PressRelease.aspx?PageID=1242, accessed August 15, 2012. 3. World Health Organization, “Definition of Cardiovascular Diseases,” accessed August 16, 2012, http://www.euro.who.int/en/what-we-do/health-topics/noncommunicable-diseases/cardiovascular-diseases/definition.
