Neuropsychological Functioning in Pediatric Primary Headache Disorders: A Meta-Analysis.

Objective: To evaluate whether neuropsychological functioning was impaired among individuals with pediatric primary headache disorders (PHD) compared with individuals without headaches. Adults with migraine appear to evidence deficits in neuropsychological performance, but few reviews have examined whether cognitive performance is impaired among children and adolescents with primary headache disorders.

Methods: we considered studies using a validated clinical neuropsychological measure among pediatric samples (<20-y old) that included a phd and control sample. two authors independently reviewed candidate articles to determine inclusion and to extract data. data were pooled using random-effects models. data sources: pubmed, embase, proquest health & medical, proquest psychology database, and psycinfo were searched from inception to february 2024.

Results: Analysis of 16 included studies indicated significantly worse overall neuropsychological performance among pediatric PHD (g = -0.31; 95% CI = -0.44 to -0.17), as well as significantly worse performance across the motor, executive function, learning/memory, language, processing speed, intelligence, and visuospatial/construction domains, as compared with nonheadache controls. Moderate heterogeneity was observed (I2 = 43.13%) but analyses of publication bias and moderators were not significant. Sensitivity analyses indicated that negative effects were driven by samples with migraine and not observed among tension-type headache (TTH) samples.

Conclusions: Relative to controls without headache, pediatric samples with migraine demonstrate worse neurocognitive performance both generally and across specific domains. A small number of studies among samples with TTH were included and moderator analyses were likely underpowered.