O'Bryant Sid E, Marcus Dawn A, Rains Jeanetta C, Penzien Donald B
Department of Neuropsychiatry, Texas Tech University Health Sciences Center, Lubbock, TX 79430-8321, USA.
Headache. 2006 Oct;46(9):1364-76. doi: 10.1111/j.1526-4610.2006.00579.x.
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.
头痛被认为是最常见的神经系统疾病之一，也是头部、脑部或颈部受伤后最常报告的症状。尽管近年来出现了关于头痛患者中枢神经系统异常的研究，但对相关功能损害的了解却较少。关于头痛神经心理学后果的研究文献远未得出定论。偏头痛的研究最为广泛，有一些一致的证据表明，在偏头痛发作期间及发作之间，认知会发生细微但可能具有重大意义的变化。有先兆的偏头痛患者似乎也比无先兆的偏头痛患者出现更多的神经心理学缺陷。虽然致力于了解偏头痛患者神经认知特征的文献在不断增加，但针对紧张型头痛和创伤后头痛（PTHA）神经心理学的研究却少得多。有迹象表明，紧张型头痛患者的神经心理学功能比对照组差，但证据并不确凿。PTHA人群在创伤的程度和部位、既往头痛状况以及其他与损伤相关的变量方面差异很大，因此各研究之间几乎无法进行归纳总结。本文总结了有关偏头痛、紧张型头痛和PTHA相关认知症状的研究，概述了头痛药物的认知副作用，并探讨了临床意义以及未来研究的重点。
