Chiappedi Matteo, Mensi Martina, Antonaci Eliana, Zavani Elena, Tronconi Livio, Termine Cristiano, Balottin Umberto
IRCCS Mondino Foundation, Pavia, Italy.
Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
Front Neurol. 2018 Mar 6;9:128. doi: 10.3389/fneur.2018.00128. eCollection 2018.
There are few literature evidences about the intellectual profile of adolescents with headache and no study has used the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in patients with a diagnosis of headache according to the ICHD-III-beta. We recruited 30 patients (age 11-14 years; male:female = 1:2) seen for headache in a tertiary center in Northern Italy and 30 healthy controls matched for age and sex, recruited in a public school from the same geographic area. The diagnosis of headache was done according to the ICHD-III criteria (beta version): the case group was composed of 16 patients with migraine and 14 with tension-type headache. Cognitive functioning was assessed using the WISC-IV. Recruited patients with idiopathic headache diagnosis had on average a cognitive function within the normal range. We found no statistically significant differences in the total Intellective Quotient comparing patients with headache and controls; the Working Memory Index was, however, lower in patients with headache ( = 0.012), and in particular, we found a lower Digit Span ( < 0.001). We also found a borderline statistical difference ( = 0.051) between case and controls Verbal Comprehension Index (CVI), which was due to a lower score in the Similarities subtest ( < 0.001). Our results suggest that, although within normal limits, cognitive functioning of adolescents with headache differs from that of healthy peers regarding memory and verbal skills. The Working Memory Index is related to the subject's ability to store new information and keep them in short-term memory, to maintain focused attention and to manipulate them to find solutions. The difference in Similarities is also important because it provides a measure of the level of verbal reasoning and concept formation; it is also a measure of verbal abstract thinking skills relevant for language development, lexical knowledge, auditory comprehension, memory, and ability to discriminate between essential and non-essential characteristics. Our data, in keep with previous findings, suggest the need for further researches to better understand the pathogenesis of these difficulties and obtain ideas for an adequate rehabilitative treatment.
关于头痛青少年的智力特征，几乎没有文献证据，并且尚无研究针对根据国际头痛疾病分类第三版（ICHD-III-beta）诊断为头痛的患者使用韦氏儿童智力量表第四版（WISC-IV）。我们招募了30名在意大利北部一家三级中心因头痛就诊的患者（年龄11 - 14岁；男:女 = 1:2），以及30名年龄和性别相匹配的健康对照，后者是从同一地理区域的一所公立学校招募的。头痛的诊断依据ICHD-III标准（beta版）：病例组由16名偏头痛患者和14名紧张型头痛患者组成。使用WISC-IV评估认知功能。招募的特发性头痛诊断患者的认知功能平均在正常范围内。我们发现，比较头痛患者和对照组，总智商没有统计学上的显著差异；然而，头痛患者的工作记忆指数较低（= 0.012），特别是，我们发现数字广度较低（< 0.001）。我们还发现病例组和对照组的言语理解指数（CVI）之间存在临界统计学差异（= 0.051），这是由于相似性分测验得分较低（< 0.001）。我们的结果表明，尽管在正常范围内，但头痛青少年的认知功能在记忆和言语技能方面与健康同龄人不同。工作记忆指数与受试者存储新信息并将其保持在短期记忆中、保持注意力集中以及对其进行操作以找到解决方案的能力相关。相似性方面的差异也很重要，因为它提供了言语推理和概念形成水平的一种度量；它也是与语言发展、词汇知识、听觉理解、记忆以及区分基本和非基本特征能力相关的言语抽象思维技能的一种度量。我们的数据与先前的研究结果一致，表明需要进一步研究以更好地理解这些困难的发病机制，并获得适当康复治疗的思路。
