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Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients - a cross sectional study.
J Headache Pain. 2020 May 24; 21(1):56.JH

Abstract

BACKGROUND

Vestibular symptoms and balance changes are common in patients with migraine, especially in the ones with aura and chronic migraine. However, it is not known if the balance changes are determined by the presence of vestibular symptoms or migraine subdiagnosis. Therefore, the aim of this study was to verify if the migraine subdiagnosis and/or the presence of vestibular symptoms can predict balance dysfunction in migraineurs.

METHODS

The study included 49 women diagnosed with migraine with aura, 53 without aura, 51 with chronic migraine, and 54 headache-free women. All participants answered a structured questionnaire regarding migraine features and presence of vestibular symptoms, such as dizziness/vertigo. The participants performed the Modified Sensory Organization Test on an AMTI© force plate. The data were analysed using a linear mixed-effect regression model.

RESULTS

The presence of vestibular symptoms did not predict postural sway, but the subdiagnosis was a significant predictor of postural sway. Migraine with aura patients exhibited more sway than migraine patients without aura when the surface was unstable. Additionally, we found high effect sizes (ES > 0.79) for postural sway differences between patients with chronic migraine or with aura compared to controls or migraine without aura, suggesting that these results are clinically relevant.

CONCLUSIONS

The subdiagnosis of migraine, instead of the presence of vestibular symptoms, can predict postural control impairments observed in migraineurs. This lends support to the notion that balance instability is related to the presence of aura and migraine chronicity, and that it should be considered even in patients without vestibular symptoms.

Authors+Show Affiliations

Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.Department of Psychology, University of Lübeck, Lübeck, Germany.Department of Ear, Nose and Throat, San Raffaele University Hospital, Milan, Italy.Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil. deborabg@fmrp.usp.br.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32448118

Citation

Zorzin, Letícia, et al. "Subdiagnosis, but Not Presence of Vestibular Symptoms, Predicts Balance Impairment in Migraine Patients - a Cross Sectional Study." The Journal of Headache and Pain, vol. 21, no. 1, 2020, p. 56.
Zorzin L, Carvalho GF, Kreitewolf J, et al. Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients - a cross sectional study. J Headache Pain. 2020;21(1):56.
Zorzin, L., Carvalho, G. F., Kreitewolf, J., Teggi, R., Pinheiro, C. F., Moreira, J. R., Dach, F., & Bevilaqua-Grossi, D. (2020). Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients - a cross sectional study. The Journal of Headache and Pain, 21(1), 56. https://doi.org/10.1186/s10194-020-01128-z
Zorzin L, et al. Subdiagnosis, but Not Presence of Vestibular Symptoms, Predicts Balance Impairment in Migraine Patients - a Cross Sectional Study. J Headache Pain. 2020 May 24;21(1):56. PubMed PMID: 32448118.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients - a cross sectional study. AU - Zorzin,Letícia, AU - Carvalho,Gabriela F, AU - Kreitewolf,Jens, AU - Teggi,Roberto, AU - Pinheiro,Carina F, AU - Moreira,Jéssica R, AU - Dach,Fabíola, AU - Bevilaqua-Grossi,Débora, Y1 - 2020/05/24/ PY - 2020/03/20/received PY - 2020/05/19/accepted PY - 2020/5/26/entrez PY - 2020/5/26/pubmed PY - 2020/10/6/medline KW - Dizziness KW - Headache KW - Migraine KW - Postural balance KW - Vestibular migraine SP - 56 EP - 56 JF - The journal of headache and pain JO - J Headache Pain VL - 21 IS - 1 N2 - BACKGROUND: Vestibular symptoms and balance changes are common in patients with migraine, especially in the ones with aura and chronic migraine. However, it is not known if the balance changes are determined by the presence of vestibular symptoms or migraine subdiagnosis. Therefore, the aim of this study was to verify if the migraine subdiagnosis and/or the presence of vestibular symptoms can predict balance dysfunction in migraineurs. METHODS: The study included 49 women diagnosed with migraine with aura, 53 without aura, 51 with chronic migraine, and 54 headache-free women. All participants answered a structured questionnaire regarding migraine features and presence of vestibular symptoms, such as dizziness/vertigo. The participants performed the Modified Sensory Organization Test on an AMTI© force plate. The data were analysed using a linear mixed-effect regression model. RESULTS: The presence of vestibular symptoms did not predict postural sway, but the subdiagnosis was a significant predictor of postural sway. Migraine with aura patients exhibited more sway than migraine patients without aura when the surface was unstable. Additionally, we found high effect sizes (ES > 0.79) for postural sway differences between patients with chronic migraine or with aura compared to controls or migraine without aura, suggesting that these results are clinically relevant. CONCLUSIONS: The subdiagnosis of migraine, instead of the presence of vestibular symptoms, can predict postural control impairments observed in migraineurs. This lends support to the notion that balance instability is related to the presence of aura and migraine chronicity, and that it should be considered even in patients without vestibular symptoms. SN - 1129-2377 UR - https://www.unboundmedicine.com/medline/citation/32448118/Subdiagnosis_but_not_presence_of_vestibular_symptoms_predicts_balance_impairment_in_migraine_patients___a_cross_sectional_study_ DB - PRIME DP - Unbound Medicine ER -