Frontal lobe dysfunction in patients with chronic migraine: a clinical–neuropsychological study

Neuropsychological tests have demonstrated a frontal lobe dysfunction in several psychiatric and neurological disorders. Our purpose was to examine whether similar functional differences would be found in patients with chronic migraine. The Gambling Task (GT), the Tower of Hanoi-3 (TOH-3) and the Object Alternation Test (OAT) were administered to 23 female patients previously treated for chronic migraine and to 23 healthy women who were similar to the patients in age and educational level, and the mean test scores of the two groups were compared (Student's t and Pearson correlation coefficient). The patient group scored significantly higher than the controls on the TOH-3 and, especially, the OAT. In the patients, no significant relationship was found between the neuropsychological test scores and those for the Minnesota Multiple Personality Inventory (MMPI), the Spielberg State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In conclusion, the data suggest a relation between chronic headache and dorsolateral function (as tested by the TOH-3) and orbitofrontal function (as tested by the OAT). The decision-making function related to ventromedial prefrontal cortex (tested by the GT) did not show a statistically significant difference between patients and controls. These neuropsychological findings seem to be partly independent of the patient's psychological traits and psychiatric disorders.