PO-02 | Migraine in youth: a double challenge to cognition and emotion

Samuela Tarantino,¹ Martina Proietti Checchi,¹ Laura Papetti,¹ Fabiana Ursitti,¹ Gabriele Monte,¹ Giorgia Sforza,¹ Massimiliano Valeriani,^1-3 | ¹Developmental Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy; ²Systems Medicine Department, Tor Vergata University of Rome, Rome, Italy; ³Translational Pain Neuroscience and Precision Medicine, CNAP, Dept. of Health Science and Technology, School of Medicine, Aalborg University, Denmark

Background: Pediatric migraine is frequently associated with cognitive difficulties and internalizing symptoms, potentially affecting academic and social functioning. This study aimed to examine the associations between migraine frequency, age of onset, and prophylactic treatment use with cognitive and emotional functioning in children and adolescents.

Methods: Fifty-two patients (mean age = 12.60 ± 2.47 years; 31 females, 21 males) with migraine were assessed using a comprehensive battery: verbal memory (Digit Span Forward/Backward, BVN 5-18), verbal fluency (BVN 5-18), attention and executive functioning (NEPSY-II: Visual Attention, Inhibition), processing speed (SDMT), intelligence (Raven’s Colored Progressive Matrices), and internalizing symptoms (SAFA-A, SAFA-D). Migraine frequency was classified as high (weekly/daily) or low (≤3/month), and patients were grouped by prophylactic treatment use in the past year. Migraine onset (in months/years) was recorded.

Results: Among participants completing the NEPSY-II Inhibition task, 47.7% scored below average at time 1, 43.2% at time 2, and 40.9% at time 3. No significant differences were found in visual attention or overall inhibition scores between groups (p > 0.05). However, both the high-frequency migraine group and those receiving prophylactic treatment scored significantly lower on backward digit span (p = 0.00 and p = 0.01, respectively). No group differences emerged in processing speed, verbal fluency, or Raven’s scores (p > 0.05). The high-frequency group showed significantly higher levels of generalized anxiety, school-related anxiety, and guilt (p = 0.04, p = 0.03, and p = 0.04, respectively).

Conclusion: These results support two key hypotheses: (1) migraine-related fatigue may impair working memory and increase emotional vulnerability; and (2) heightened anxiety may reduce cognitive efficiency, especially in tasks requiring sustained mental effort, such as working memory.