Does Migraine Have Long-Term Effects on the Brain? Here’s What You Should Know

Migraine can structurally change the brain but hasn’t been linked to cognitive impairment or other neurological issues. These changes don’t happen for everyone with migraine.

Migraine can be so painful and life-altering that you might wonder how it affects the brain, or even if a migraine attack can damage the brain.

Though there is some limited evidence that migraine can alter certain brain structures, there’s no need for alarm.

While it might sound scary, knowing how and to what extent migraine affects the brain may also empower you to be proactive in your treatment.

Read on to learn more about migraine and brain changes.

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Does migraine have long-term effects on the brain?

The short answer is that migraine may structurally change the brain in the long term, but take this information with a grain of salt. More research is needed to confirm whether this is the case.

Also, if changes do occur, they don’t happen to everyone, and they have not been linked to cognitive impairment or wider neurological issues.

A 2021 review looked at existing research that used neuroimaging, including functional magnetic resonance imaging (fMRI), to study structural brain changes in people with migraine.

These changes included:

• volume changes in white and gray matter
• brain lesions
• other white matter abnormalities
• altered neuronal connectivity
• abnormal energy metabolism

The review authors noted that a better understanding of these brain alterations could lead to improved options for targeted anti-migraine therapy.

White matter lesions have been found to be two to four times more common among people who experience migraine with aura than the general public.

An older 2017 systematic review found multiple areas of reduced gray matter volume, which could be related to pain processing and blood flow abnormalities.

Research from 2021 has also found temporary differences in cortical thickness during migraine attacks compared to people not experiencing an attack. Those changes revert when the attack ends.

Research isn’t conclusive

Research is mixed. Some studies have found greater cortical thickness among people with migraine, whereas others have found areas of reduced thickness.

Remember that many of these studies are small, some contradicted each other, and varying imaging techniques were used. This makes comparison difficult.

Many studies have not had their results replicated. Additionally, it’s not always possible to say if migraine caused these brain changes, or if the brain differences were already there and even contributed to migraine.

Ultimately, the evidence — and the understanding — of migraine’s effects on the brain is limited. According to the American Migraine Foundation, you shouldn’t overestimate the implications of these reported brain changes.

Migraine and cognitive function

Migraine attacks can lead to functional changes in the brain — in other words, your brain’s “performance.” This means you might notice changes in your thinking, reasoning, and memory.

“Brain fog” can occur during the 48 hours before and 24 hours after the headache phase of a migraine attack. During this time, you might have difficulty with focus, finding the right word, remembering important things, and concentrating.

Migraine is not related to dementia or cognitive decline

2020 research found that migraine is not associated with either dementia or age-related cognitive decline. The study compared people over the age of 50 with migraine to healthy controls over a 5-year period and found that cognitive changes were identical between groups.

Still, there’s a need for further research to better understand the relationship between migraine and cognitive function.

Migraine and mental health

There’s a likely bidirectional relationship between migraine and emotional well-being.

People with migraine are two to four times more likely to have depression and anxiety than the general public. Living with migraine can be unpredictable, painful, and challenging. This can all negatively impact your mental health.

On the flip side, depression and anxiety could put you at higher risk of migraine, possibly due to shared mechanisms like serotonin dysregulation.

A 2022 study found that the risk for migraine in people with clinical anxiety and depression nearly doubled over an 11-year follow-up.

Minimizing the long-term effects of migraine

There’s still a lot to learn about how migraine may or may not change the brain and whether there are steps you can take to minimize those changes.

However, there are still many ways you can cope with the long-term effects of migraine in general.

Early intervention is important, whether that’s seeing a neurologist or starting abortive medication when pain is still mild.

Abortive migraine medications include:

• over-the-counter pain relievers
• prescriptions NSAIDs
• triptans
• antiemetics
• calcitonin gene-related peptide (CGRP) antagonists

Preventive medications are also important. These are medications that you take in between episodes, and they can improve your quality of life and make you respond better to your abortive medications.

These include:

• beta-blockers
• anti-convulsants
• antidepressants
• calcium-channel blockers

Lifestyle modifications can also be very helpful when it comes to managing migraine long-term. Some strategies include:

• Keep a headache diary to monitor potential triggers.
• Get enough sleep and practice sleep hygiene.
• Get regular exercise (30 to 50 minutes, 3 to 5 days a week).
• Stay hydrated.
• Eat a healthy, balanced diet.
• Practice stress management.
• Try complementary treatments, like acupuncture or green light therapy.

Takeaway

The research on migraine and brain changes is mixed, but it does indicate that people with migraine have some noticeable brain differences when compared to people without migraine.

These changes haven’t been linked to any impairment in cognition. It’s also possible that in some cases migraine didn’t cause the brain differences, but that these differences are what contributed to migraine in the first place.

The best thing to focus on is managing your medications, triggers, and stress levels.