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Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine

Vestibular Migraine (VM) is the most common cause of non-positional episodic vestibular symptoms. Patients with VM commonly report increased motion sensitivity, suggesting that vestibular responses to head movement may identify changes specific to VM patients. Here we explore whether the vestibulo-o...

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Autores principales: Patel, Priyani, Castro, Patricia, Koohi, Nehzat, Arshad, Qadeer, Gargallo, Lucia, Carmona, Sergio, Kaski, Diego
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561915/
https://www.ncbi.nlm.nih.gov/pubmed/36247796
http://dx.doi.org/10.3389/fneur.2022.967521
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author Patel, Priyani
Castro, Patricia
Koohi, Nehzat
Arshad, Qadeer
Gargallo, Lucia
Carmona, Sergio
Kaski, Diego
author_facet Patel, Priyani
Castro, Patricia
Koohi, Nehzat
Arshad, Qadeer
Gargallo, Lucia
Carmona, Sergio
Kaski, Diego
author_sort Patel, Priyani
collection PubMed
description Vestibular Migraine (VM) is the most common cause of non-positional episodic vestibular symptoms. Patients with VM commonly report increased motion sensitivity, suggesting that vestibular responses to head movement may identify changes specific to VM patients. Here we explore whether the vestibulo-ocular reflex (VOR) gain alters in response to a clinical “headshake” maneuver in patients with VM. Thirty patients with VM in the inter-ictal phase, 16 patients with Benign Positional Paroxysmal Vertigo (BPPV) and 15 healthy controls were recruited. Patients responded to the question “Do you feel sick reading in the passenger seat of a car?” and completed a validated motion sickness questionnaire as a measure of motion sensitivity. Lateral canal vHIT testing was performed before and after headshaking; the change in VOR gain was calculated as the primary outcome. Baseline VOR gain was within normal limits across all participants. There was no significant change in VOR gain after headshaking in any group (p = 0.264). Patients were 4.3 times more likely to be in the VM group than in the BPPV group if they reported nausea when reading in the passenger seat of a car. We postulate that a headshake stimulus may be insufficient to disrupt cortical interactions and induce a change in VOR gain. Alternatively, changes in VOR gain may only be apparent in the acute phase of VM. Reading in the passenger seat of a car was considered uncomfortable in all VM patients suggesting that this specific question may be useful for the diagnosis of VM.
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spelling pubmed-95619152022-10-15 Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine Patel, Priyani Castro, Patricia Koohi, Nehzat Arshad, Qadeer Gargallo, Lucia Carmona, Sergio Kaski, Diego Front Neurol Neurology Vestibular Migraine (VM) is the most common cause of non-positional episodic vestibular symptoms. Patients with VM commonly report increased motion sensitivity, suggesting that vestibular responses to head movement may identify changes specific to VM patients. Here we explore whether the vestibulo-ocular reflex (VOR) gain alters in response to a clinical “headshake” maneuver in patients with VM. Thirty patients with VM in the inter-ictal phase, 16 patients with Benign Positional Paroxysmal Vertigo (BPPV) and 15 healthy controls were recruited. Patients responded to the question “Do you feel sick reading in the passenger seat of a car?” and completed a validated motion sickness questionnaire as a measure of motion sensitivity. Lateral canal vHIT testing was performed before and after headshaking; the change in VOR gain was calculated as the primary outcome. Baseline VOR gain was within normal limits across all participants. There was no significant change in VOR gain after headshaking in any group (p = 0.264). Patients were 4.3 times more likely to be in the VM group than in the BPPV group if they reported nausea when reading in the passenger seat of a car. We postulate that a headshake stimulus may be insufficient to disrupt cortical interactions and induce a change in VOR gain. Alternatively, changes in VOR gain may only be apparent in the acute phase of VM. Reading in the passenger seat of a car was considered uncomfortable in all VM patients suggesting that this specific question may be useful for the diagnosis of VM. Frontiers Media S.A. 2022-09-30 /pmc/articles/PMC9561915/ /pubmed/36247796 http://dx.doi.org/10.3389/fneur.2022.967521 Text en Copyright © 2022 Patel, Castro, Koohi, Arshad, Gargallo, Carmona and Kaski. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Patel, Priyani
Castro, Patricia
Koohi, Nehzat
Arshad, Qadeer
Gargallo, Lucia
Carmona, Sergio
Kaski, Diego
Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine
title Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine
title_full Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine
title_fullStr Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine
title_full_unstemmed Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine
title_short Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine
title_sort head shaking does not alter vestibulo ocular reflex gain in vestibular migraine
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561915/
https://www.ncbi.nlm.nih.gov/pubmed/36247796
http://dx.doi.org/10.3389/fneur.2022.967521
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