Migraine is a functional brain disorder classified into episodic migraine (EM) and chronic migraine (CM). Migraine symptoms  include pain, nausea, photophobia and phonophobia, but many patients report cognitive dysfunction, functional impairments and fatigue.  These symptoms are present in EM but appear to be significantly more severe in CM. 

All new patients at a tertiary headache clinic complete a detailed patient intake questionnaire prior to their first visit. The specific headache diagnoses are entered according to ICHD-3. We included questions regarding confusion, decreased abilityto concentrate, fatigue, problems with memory, depressed mood, anxious mood, and trouble sleeping.

We found that significant proportion of patients with migraine headache endorsed subjective cognitive issues that trouble them as much as pain itself. Symptoms such as anxiety, depression, problems with sleep, and fatigue are also common and more common in CM. Most of these patients have normal neurological examinations, brain imaging, and no history of traumatic brain injury.  These  symptoms may be related to changes in functional connectivity which have previously been observed in migraineurs.