# Cognitive impairment in tension-type headache is associated with altered hippocampal functional connectivity

## TL;DR

Tension-type headache patients with cognitive issues show changes in brain regions linked to pain and memory, suggesting a possible link to dementia risk.

## Contribution

Identifies hippocampal and subiculum functional changes associated with cognitive impairment in tension-type headache patients.

## Key findings

- Significant functional alterations in subiculum, hippocampal fissure, and left hippocampus in TTH patients.
- Right subiculum activity correlates with MoCA scores and pain intensity in TTH patients.
- Hippocampal and middle temporal regions are linked to cognitive decline in TTH.

## Abstract

Tension-type headache (TTH) is a widespread primary headache disorder that causes mild to moderate pain, which may be seen together with cognitive deficits. It is unclear if TTH-linked cognitive impairment is associated with functional alterations. Seventy-five participants were enrolled in the study. Mini Mental State Evaluation (MMSE) and Montreal Cognition Assessment (MoCA) tests were applied to evaluate cognitive impairment. A neuroimaging analysis was applied to determine whether the hippocampus responsible for pain and cognition was affected in TTH patients. Our functional data revealed significant alterations in the connectivity of the subiculum, hippocampal fissure, and left whole hippocampus. Among the significant functional brain alterations observed, the right subiculum consistently interacted with MoCA scores and increased pain intensity. Our findings suggest that TTH patients with cognitive impairment may exhibit unique functional alterations in the hippocampus. This suggests a potential negative association between pain modulation and cognitive processes in the hippocampus that may be responsible for the increased risk of dementia in these patients.

•The right subiculum, middle temporal, and frontal gyrus process both pain and cognition•Hippocampal and middle temporal regions relate to cognitive decline in TTH pathology•MoCA scores and pain intensity are negatively correlated in the TTH group

The right subiculum, middle temporal, and frontal gyrus process both pain and cognition

Hippocampal and middle temporal regions relate to cognitive decline in TTH pathology

MoCA scores and pain intensity are negatively correlated in the TTH group

Clinical neuroscience; Cognitive neuroscience