[Mental processing in primary headache in children and adolescents]

Abstract

Introduction: Headaches in children and adolescents are the most common complaints in neurological practice. More than 90% of those are diagnosed as having migraine or tension-type headache (TTH). Memory disturbances are the most frequently observed symptoms in these patients. Event related potentials ( ERP), especially P300 potential reflect the processes of perception and cognition. The aim of these studies was to answer two questions: whether children and adolescents suffering from headache, especially migraine, show cognitive impairment in headache pain free period in comparison to healthy controls, and secondly what kind of factors can influence it.

Materials and methods: 125 patients participated in these examinations with 90 ones with migraine and 35 those with TTH, diagnosed according to the criteria of International Headache Society (IHS-2004). Control group for neurophysiological examinations consisted of 66 healthy children and adolescents of the same age. ERPs were performed for patients with migraine and TTH in headache pain-free interval with the minimum period of, at least, one week since the last incident. International Federation of Clinical Neurophysiology (IFCN) recommendations for recording and analysing the results were used. Evoked potentials examinations were performed using 4-channel Multiliner (Toennies, Germany). Endogenous evoked potentials (P300) were recorded using the ,,oddball paradigm"'. The reception of potentials was completed by unipolar method with far-field recording (Fz, Cz, Pz and 10, EOG, to 10-20 system). The latencies of the first negative wave N1, next positive P2, the following N2 negative and positive component P300 were evaluated. Moreover, the amplitude differences N1-P2, P2-N2, N2-P3 were analysed.

Results: Substantially longer latency of P300 component was noted for patients with migraineous headaches in comparison to the values recorded in children with TTH. Prolongation of N1 latency and the rise of N1-P2, P2-N2, graine in comparison to controls. The type of the observed aura did not change essentially the character of the alterations described above.

Conclusion: Prolongation of N1 latency and the rise of N1-P2, P2-N2, N2-P3 amplitudes confirm the presence of cognitive disturbances mostly in children and adolescents suffering from migraine.