Migraine and balance impairment: Influence of subdiagnosis, otoneurological function, falls, and psychosocial factors.

Szczegóły
Abstrakt

Tytuł:: Migraine and balance impairment: Influence of subdiagnosis, otoneurological function, falls, and psychosocial factors.
Autorzy:: Carvalho GF; Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.; Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Germany.
Luedtke K; Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Germany.; Laboratory of Pain Research, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
Pinheiro CF; Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Moraes R; School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Lemos TW; Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Carneiro CG; Department of Ophthalmology, Otolaryngology and Head & Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Bigal ME; Ventus Therapeutics, Montreal, Quebec, Canada.
Dach F; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Bevilaqua-Grossi D; Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Źródło:: Headache [Headache] 2022 May; Vol. 62 (5), pp. 548-557.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: <2008- > : Hoboken, NJ : Wiley
Original Publication: St. Louis : American Association for the Study of Headache
MeSH Terms:: Epilepsy*/complications
Migraine Disorders*/complications
Migraine Disorders*/diagnosis
Migraine with Aura*
Cross-Sectional Studies ; Dizziness/diagnosis ; Dizziness/etiology ; Humans ; Postural Balance ; Vertigo/complications ; Vertigo/diagnosis
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Contributed Indexing:: Keywords: aura; computerized dynamic posturography; postural balance; primary headache disorders; vestibular function tests; vestibular migraine
Entry Date(s):: Date Created: 20220520 Date Completed: 20220524 Latest Revision: 20220822
Update Code:: 20240105
DOI:: 10.1111/head.14309
PMID:: 35593785
: Czasopismo naukowe

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Objective: To assess the balance sensory organization among patients with migraine, considering the influence of migraine subdiagnosis, otoneurological function, falls, and psychosocial factors.
Background: Migraine has been associated with vestibular symptoms and balance dysfunction; however, neither comprehensive balance assessment nor associated factors for greater impairment have been addressed thus far.
Methods: Patients from a tertiary headache clinic with a diagnosis of episodic migraine with aura (MWA), without aura (MWoA), and chronic migraine (CM) were included for this cross-sectional study (30 patients per group). Thirty headache-free controls (CG) were recruited. Participants underwent a comprehensive evaluation protocol, including the Sensory Organization Test (SOT) and otoneurological examination. Questionnaires about fear of falls, dizziness disability, and kinesiophobia were administered.
Results: All migraine groups presented lower composite SOT scores than controls (CG: 82.4 [95% confidence interval (CI): 79.5-85.3], MWoA: 76.5 [95% CI: 73.6-79.3], MWA: 66.5 [95% CI: 63.6-69.3], CM: 69.1 [95% CI: 66.3-72.0]; p < 0.0001). Compared to controls and to MWoA, MWA and CM groups exhibited greater vestibular (CG: 75.9 [95% CI: 71.3-80.4], MWoA: 67.3 [95% CI: 62.7-71.8], MWA: 55.7 [95% CI: 51.2-60.3], CM: 58.4 [95% CI: 53.8-63.0]; p < 0.0001) and visual functional impairment (CG: 89.6 [95% CI: 84.2-94.9], MWoA: 83.2 [95% CI: 77.9-88.6], MWA: 68.6 [95% CI: 63.3-74.0], CM: 71.9 [95% CI: 66.5-77.2], p < 0.0001). Fall events during the assessment were documented more often among patients with migraine (CG: 0.0, interquartile range [IQR], 0.0, 0.0); MWoA: 1.0 [IQR: 1.0, 1.0], MWA: 2.0 [IQR: 1.8, 4.3], CM: 1.0 [IQR: 1.0, 2.0]; p = 0.001). The SOT scores correlated with fear of falls (r = -0.44), dizziness disability (r = -0.37), kinesiophobia (r = -0.38), and migraine frequency (r = -0.38). There was no significant influence of the vestibular migraine diagnosis in the study outcomes when used as a covariate in the analysis (composite score [F = 3.33, p = 0.070], visual score [F = 2.11, p = 0.149], vestibular score [F = 1.88, p = 0.172], somatosensory score [F = 0.00, p = 0.993]).
Conclusions: Aura and greater migraine frequency were related to falls and balance impairment with sensory input manipulation, although no otoneurological alterations were detected. The diagnosis of vestibular migraine does not influence the balance performance. The vestibular/visual systems should be considered in the clinical examination and treatment of patients with migraine.
(© 2022 The Authors. Headache: The Journal of Head and Face Pain published by Wiley Periodicals LLC on behalf of American Headache Society.)

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