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Background and Purpose Neuropsychological and neuroimaging studies both suggest that frontal lobe dysfunction is present in migraineurs. Since P3a abnormalities manifest in other diseases associated with attention problems, such as attention deficit hyperactivity disorder, we hypothesized that migraine patients have P3a abnormalities, particularly in the frontal region. Methods Event-related potentials were measured using a passive auditory oddball paradigm in 16 female migraineurs (aged 22.9±2.0 years, mean±SD) during the interictal period and in 16 age-matched healthy females (22.6±2.0 years). The amplitudes and latencies were analyzed independently using repeated-measures analysis of variance. Nonparametric statistical testing using a cluster-level randomization method was performed to localize the abnormalities. Results The mean P3a amplitude at frontal areas during the third trials was significantly lower in migraineurs (1.06 μV) than in controls (1.69 μV, p=0.026). P3a amplitudes were negatively correlated with the duration of the migraine history (r=-0.618, p=0.014). Cluster-based nonparametric statistical analysis showed that the amplitudes over left frontal areas were significantly lower in migraine patients than in controls. Conclusions A reduced P3a amplitude of migraineurs reflects attentional deficits and frontal dysfunction. The negative correlation between P3a amplitude and the duration of the migraine history suggests that attentional deficits and frontal dysfunction are either the cause or the result of headache. J Clin Neurol 2013;9:43-50

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