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The Neuropsychology of Recurrent Headache


  • Sid E. O'Bryant PhD,

  • Dawn A. Marcus MD,

  • Jeanetta C. Rains PhD,

  • Donald B. Penzien PhD

  • From the Texas Tech University Health Sciences Center, Department of Neuropsychiatry, Lubbock, TX (Dr. O'Bryant); Pain Evaluation and Treatment Institute, Pittsburgh, PA (Dr. Marcus); Center for Sleep Evaluation, Elliot Hospital, Manchester, NH (Dr. Rains); Head Pain Center, Department of Psychiatry, University of Mississippi Medical Center, Jack son, MS (Dr. Penzien).

Address all correspondence to Dr. Sid E. O'Bryant, Texas Tech University Health Sciences Center, Department of Neuropsychiatry and Behavioral Sciences, 3601 4th Street. STOP 8321, Lubbock, TX 79430-8321.


Headache is recognized as one of the most prevalent neurological disorders, and is the most frequently reported symptom following injury to the head, brain, or neck. Although studies of central nervous system abnormalities in headache sufferers have emerged in recent years, less is known about the associated functional impairments. The research literature addressing neuropsychological consequences of headache has been far from conclusive. Migraine has been most extensively studied, with some consistent evidence of subtle but potentially significant changes in cognition occurring during and between migraine episodes. It also appears likely that migraine patients with aura experience more neuropsychological deficits than those without aura. While the literature devoted to understanding the neurocognitive profile of migraine sufferers is growing, much less research has addressed the neuropsychology of tension-type headache and posttraumatic headache (PTHA). There is some suggestion of poorer neuropsychological function in tension-type headache than controls, but the evidence is inconclusive. The PTHA population is highly varied in degree and location of trauma, preexisting headache condition, and other injury-related variables, allowing little generalization across studies. This paper summarizes research regarding the cognitive symptoms associated with migraine, tension-type headache, and PTHA, provides an overview of the cognitive side effects of headache medications, and addresses clinical implications and priorities for future research.