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Chronic <jats:styled-content style=\"fixed-case\">TTH<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content>), the most serious form of <jats:styled-content style=\"fixed-case\">TTH<\/jats:styled-content>, is refractory, with a high socio\u2010economic burden. Research studies have shown patients with migraine often had cognitive impairment, but few studies have focused on the cognition in patients with <jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content>. In this study, we assumed that patients with <jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content> also have cognitive impairments, which are modulated by the neuroendocrine state. Participants were recruited, including patients with <jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content> and healthy controls. Cognitive ability was evaluated using the Montreal Cognitive Assessment and the Nine Box Maze Test. The administration of neuroendocrine hormones has been established to be associated with cognitive performance, and we detected the hormonal changes in the hypothalamus\u2013pituitary\u2013adrenal axis, the hypothalamus\u2013pituitary\u2013thyroid axis, and gonadotropin\u2010releasing hormone. These results showed that compared to the controls, significant cognitive impairment and neuroendocrine dysfunction were present in the patients with <jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content>. We also assessed the correlations between the neuroendocrine hormones and Pittsburgh Sleep Quality Index score, 17\u2010term Hamilton's Depression Scale score, pain intensity, and duration of pain to determine whether the neuroendocrine hormones had any associations with these symptoms of <jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content>. These results showed that changes in neuroendocrine hormones were involved in these symptoms of <jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content>. Intervention with the neuroendocrine state may be a strategy for <jats:styled-content style=\"fixed-case\">CTTH<\/jats:styled-content> treatment.<\/jats:p>","DOI":"10.1111\/papr.12574","type":"journal-article","created":{"date-parts":[[2017,3,25]],"date-time":"2017-03-25T08:06:36Z","timestamp":1490429196000},"page":"8-17","source":"Crossref","is-referenced-by-count":33,"title":["Cognitive Performance and the Alteration of Neuroendocrine Hormones in Chronic Tension\u2010Type Headache"],"prefix":"10.1111","volume":"18","author":[{"given":"Ping","family":"Qu","sequence":"first","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Anhui Medical University Hefei China"},{"name":"Department of Neurology The Second Affiliated Hospital of Anhui Medical University Hefei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Xia","family":"Yu","sequence":"additional","affiliation":[{"name":"Official Hospital of the People's Government Hefei 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