Abstract Details

Title Quantifying Migraine’s Cognitive Toll: Real-world Evidence from the MIND Cohort

Topic Headache

Presentation(s) S37 - Headache Clinical Trials (11:27 AM-11:39 AM)

Poster/Presentation
Number 002

Objective

To evaluate whether daily smartphone-based cognitive tests detect objective cognitive slowing on migraine headache days compared with non-headache days.

Background Patients with migraine often experience episodic cognitive difficulties, particularly in attention, processing speed, and working memory, that vary in severity across the course of an attack. Conventional in-clinic assessments cannot capture these day-to-day changes. To address this limitation, we implemented a smartphone-based ecological momentary assessment (EMA) design to measure cognition repeatedly across headache and non-headache days in the real-world setting.

Design/Methods We enrolled 129 adults with migraine via social media into the MIND (Migraine Impact on Neurocognitive Dynamics) cohort. For 30 consecutive days, participants recorded daily headache status and completed three brief smartphone tasks: Symbol Search (attention, processing speed), Color Dots (item–location binding in visual working memory), and Color Shapes (feature-binding change detection in visual working memory). We compared each participant’s performance on headache versus non-headache days, adjusting for age, sex, and test-occasion (to account for practice effects).

Results Participants had an average age of 38.1 ± 11.5 years, and 84.5% were female. On headache days, response times were slower by 6.2% on Symbol Search (β = 100.7, p < .001) and 4.0% on Color Dots (β = 67.1, p < .001), whereas the 0.8% slowing on Color Shapes was not significant (β = 12.8, p = 0.37). Accuracy rates were comparable between headache and non-headache days across all tasks.

Conclusions

Daily digital cognitive testing revealed migraine-related, task-dependent cognitive slowing that scaled with task complexity while accuracy remained unchanged. These findings support the feasibility of real-world digital endpoints for quantifying migraine-associated cognitive burden.

Authors/Disclosures
Ali Ezzati, MD (University of California, Irvine) PRESENTER	The institution of Dr. Ezzati has received research support from NIA. The institution of Dr. Ezzati has received research support from Alzheimer's Association. The institution of Dr. Ezzati has received research support from Cure Alzheimer's Fund.
Babak Khorsand, PhD	Dr. Khorsand has nothing to disclose.
Devin Teichrow, MS	Mr. Teichrow has nothing to disclose.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.

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