Written by Hannah Harp
Spoon Feed
Pediatric migraine patients display more deficits compared to their healthy peers across multiple neurocognitive domains, especially motor tasks, executive function, and learning/memory.
Developing brains derailed by pain
Primary headache disorders (PHD) in pediatric patients are common and particularly disruptive to daily activities, leading to absenteeism and poor school performance, sleep difficulties, decreased quality of life, and mood disturbances. This systematic review and meta-analysis is the first of its kind to attempt to quantify the extent of cognitive impairment for pediatric patients with PHD. Sixteen studies using validated neurocognitive assessments were pooled using random-effects models. Compared to controls, children with PHDs – especially migraine – showed significantly worse cognitive performance overall (g* = −0.31; 95%CI −0.44 to −0.17), including deficits in motor (g = −0.83), executive function (g = −0.39), memory (g = −0.36), language (g = −0.31), and processing speed (g = −0.29) domains. The cognitive inventories varied (WISC, WAIS, Conners, etc.), so when results were pooled, specific sub-domains may not have lined up for all of the studies. Collating the sub-domains of cognitive function across a variety of tests is complicated and may have affected results.
How will this change my practice?
Headaches, whether tension type or migraines, are at the heart of so many adolescent clinic visits. I usually discuss how headaches affect school attendance and performance, but now I can also emphasize that there are brain changes, not just pain, that play into the challenge.
*Editor’s note: So…I’ve never heard of “g,” except in slang terms referring to a generic person and/or gangster (colloquially “gangsta”). However, I learned that Hedges’ g (not to be confused with gangsta) is a measure of effect size, especially in small cohorts (~0.2 small, ~0.5 medium, ≥0.8 large effect). It’s similar to Cohen’s d. ~Clay Smith
Source
Neuropsychological Functioning in Pediatric Primary Headache Disorders: A Meta-Analysis. Pediatrics. 2025 May 1;155(5):e2024067838. doi: 10.1542/peds.2024-067838. PMID: 40174912
