Migraine and cognitive function: Impact on attention, memory, executive function and long-term cognitive outcomes- a structured literature review

Migraine is a highly prevalent and disabling neurological disorder whose burden extends beyond headache pain and sensory symptoms. Cognitive complaints, frequently described by patients as “brain fog,” difficulties with concentration, slowed thinking, forgetfulness, or impaired decision-making, occur across the migraine cycle and may substantially contribute to disability. This structured literature review synthesizes current evidence on cognitive function in migraine, with particular attention to attention and processing speed, memory, executive function, differences between ictal and interictal states, migraine subtype and chronicity, neurobiological mechanisms, treatment-related effects, and long-term cognitive outcomes. A structured search of PubMed/MEDLINE, Scopus, and Web of Science was designed to identify peer-reviewed studies, systematic reviews, meta-analyses, and relevant clinical guidance published primarily between January 2015 and September 2026, with selected earlier landmark studies included where necessary. The literature consistently supports reversible cognitive impairment during migraine attacks, whereas interictal findings are more heterogeneous. Recent meta-analyses suggest measurable deficits in complex attention, executive function, spatial cognition, and working memory, particularly in clinic-based and higher-burden populations. Chronic migraine, medication overuse, sleep disturbance, mood symptoms, and preventive medications may modify cognitive performance. Emerging neuroimaging and digital-assessment studies further support dynamic network-level changes across the migraine cycle. Long-term dementia risk remains debated despite recent meta-analytic signals. Cognitive symptoms should therefore be recognized as a clinically meaningful dimension of migraine and incorporated into patient-centered assessment and treatment evaluation.