NEUROVASCULARMECHANISMSANDCOGNITIVEOUTCOMESINCHRONICMIGRAINE
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Chronicmigraineisadebilitatingneurologicaldisordermarkedbyfrequentheadacheepisodesandpersistentneurobiologicalalterationsthatextendbeyondpainperception.Beyondrecurrentcephalalgia,chronicmigraineisincreasinglyrecognizedasaconditionassociatedwithchangesincerebralhemodynamicsandcognitivefunction,whichsubstantiallyimpactpatients’qualityoflife,occupationalperformance,andsocialinteractions.Investigatingthesealterationsiscrucialforelucidatingtheunderlyingpathophysiologyandoptimizingtherapeuticapproaches.Cerebralhemodynamicdisturbancesinchronicmigraineincludeimpairedregulationofcerebralbloodflow,endothelialdysfunction,alteredcerebrovascularreactivity,andregionalperfusionasymmetry.Thesechangesmayresultfromrepeatedmigraineattacks,corticalspreadingdepression,anddysregulationofautonomicandvascularcontrolmechanisms.Notably,hemodynamicabnormalitiesmaypersistduringinterictalperiods,indicatinglong-termadaptiveormaladaptivevascularchangesinthebrain.Cognitivedeficitsinchronicmigrainepatientstypicallyinvolveimpairmentsinattention,memory,executivefunctioning,andprocessingspeed.Thesedeficitsarefrequentlyaccompaniedbyemotionaldisturbances,includinganxiety,depressivesymptoms,andheightenedstresssensitivity,whichcanfurtheraggravatecognitivedecline.Theseverityofcognitiveimpairmenthasbeencorrelatedwithmigraineduration,attackfrequency,andmedicationoveruse
