CEREBRAL HEMODYNAMICS AND COGNITIVE FUNCTIONS IN CHRONIC MIGRAINE

Abstract

Chronic migraine is a disabling neurological disorder characterized by frequent headache attacks and persistent neurobiological changes that extend beyond pain perception. In addition to recurrent cephalalgia, chronic migraine is increasingly recognized as a condition associated with alterations in cerebral hemodynamics and cognitive functioning, which significantly affect patients’ quality of life, work capacity, and social functioning. The investigation of these changes is essential for understanding disease mechanisms and improving therapeutic strategies. Disturbances in cerebral hemodynamics in chronic migraine include impaired cerebral blood flow regulation, endothelial dysfunction, altered cerebrovascular reactivity, and asymmetry of regional perfusion. These changes may be associated with repeated migraine attacks, cortical spreading depression, and dysregulation of autonomic and vascular control mechanisms. Hemodynamic abnormalities can persist during the interictal period, suggesting long-term adaptive or maladaptive vascular changes in the brain. Cognitive dysfunction in patients with chronic migraine commonly involves deficits in attention, memory, executive functions, and processing speed. Such impairments are often accompanied by emotional disturbances, including anxiety, depressive symptoms, and increased stress sensitivity, which may further exacerbate cognitive decline. The severity of cognitive deficits has been shown to correlate with migraine duration, attack frequency, and the presence of medication overuse.