Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Journal of Neurology
Published in: Journal of Neurology 10/2020

01-10-2020 | Migraine | Original Communication

The integration of multisensory motion stimuli is impaired in vestibular migraine patients

Authors: Maurizio Versino, Marco Mandalà, Silvia Colnaghi, Giampietro Ricci, Mario Faralli, Stefano Ramat

Published in: Journal of Neurology | Issue 10/2020

Login to get access

Abstract

Background

Vestibular migraine (VM) is a relatively recently acknowledged vestibular syndrome with a very relevant prevalence of about 10% among patients complaining of vertigo. The diagnostic criteria for VM have been recently published by the Bárány Society, and they are now included in the latest version of the International Classification of Headache Disorders, yet there is no instrumental test that supports the diagnosis of VM.

Objective

In the hypothesis that the integration of different vestibular stimuli is functionally impaired in VM, we tested whether the combination of abrupt vestibular stimuli and full-field, moving visual stimuli would challenge vestibular migraine patients more than controls and other non-vestibular migraineurs.

Methods

In three clinical centers, we compared the performance in the functional head impulse test (fHIT) without and with an optokinetic stimulus rotating in the frontal plane in a group of 44 controls (Ctrl), a group of 42 patients with migraine (not vestibular migraine, MnoV), a group of 39 patients with vestibular migraine (VM) and a group of 15 patients with vestibular neuritis (VN).

Results

The optokinetic stimulation reduced the percentage of correct answers (%CA) in all groups, and in about 33% of the patients with migraine, in as many as 87% of VM patients and 60% of VN patients, this reduction was larger than expected from controls’ data.

Conclusions

The comparison of the fHIT results without and with optokinetic stimulation unveils a functional vestibular impairment in VM that is not as large as the one detectable in VN, and that, in contrast with all the other patient groups, mainly impairs the capability to integrate different vestibular stimuli.
Appendix
Available only for authorised users
Literature
1.
Dieterich M, Brandt T (1999) Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol 246:883–892PubMedCrossRef
2.
Strupp M, Versino M, Brandt T (2010) Vestibular migraine. In: Handbook of clinical neurology, vol 97, pp 755–771
3.
Cass SP, Ankerstjerne JKP, Yetiser S et al (1997) Migraine-related vestibulopathy. Ann Otol Rhinol Laryngol 106(3):182–189PubMedCrossRef
4.
Versino M, Sances G, Anghileri E et al (2003) Dizziness and migraine: a causal relationship? Funct Neurol 18:97–101PubMed
5.
Brandt T, Strupp M (2006) Migraine and vertigo: classification, clinical features and special treatment considerations. Headache Curr 3(1):12–19CrossRef
6.
7.
Neuhauser H, Leopold M, von Brevern M et al (2001) The interrelations of migraine, vertigo, and migrainous vertigo. Neurology 56:436–441PubMedCrossRef
8.
Neuhauser H, Lempert T (2004) Vertigo and Dizziness Related to Migraine: a Diagnostic Challenge. Cephalalgia 24:83–91PubMedCrossRef
9.
Neuhauser HK, Radtke A, von Brevern M et al (2006) Migrainous vertigo: prevalence and impact on quality of life. Neurology 67:1028–1033PubMedCrossRef
10.
Lempert T, Neuhauser H (2009) Epidemiology of vertigo, migraine and vestibular migraine. J Neurol 256:333–338PubMedCrossRef
11.
12.
Kuritzky A, Ziegler DK, Hassanein R (1981) Vertigo, motion sickness and migraine. Headache J Head Face Pain 21(5):227–231CrossRef
13.
Lempert T, Olesen J, Furman J et al (2012) Vestibular migraine: diagnostic criteria. J Vestib Res 22:167–172PubMedCrossRef
14.
Headache Classification Committee of the International Headache Society (IHS) (2018) The international classification of headache disorders, 3rd edition. Cephalalgia 38(1):1–211CrossRef
15.
von Brevern M, Lempert T (2016) Vestibular migraine. In: Handbook of clinical neurology, vol 137, pp 301–316
16.
von Brevern M, Zeise D, Neuhauser H et al (2005) Acute migrainous vertigo: clinical and oculographic findings. Brain 128:365–374CrossRef
17.
Radtke A, von Brevern M, Neuhauser H et al (2012) Vestibular migraine: long-term follow-up of clinical symptoms and vestibulo-cochlear findings. Neurology 79:1607–1614PubMedCrossRef
18.
Bir LS, Ardiç FN, Kara CO et al (2003) Migraine patients with or without vertigo: comparison of clinical and electronystagmographic findings. J Otolaryngol 32:234–238PubMedCrossRef
19.
Boldingh MI, Ljøstad U, Mygland Å, Monstad P (2013) Comparison of interictal vestibular function in vestibular migraine vs migraine without vertigo. Headache 53:1123–1133PubMedCrossRef
20.
Casani AP, Sellari-Franceschini S, Napolitano A et al (2009) Otoneurologic dysfunctions in migraine patients with or without vertigo. Otol Neurotol 30:961–967PubMedCrossRef
21.
Harno H, Hirvonen T, Kaunisto MA et al (2003) Subclinical vestibulocerebellar dysfunction in migraine with and without aura. Neurology 61:1748–1752PubMedCrossRef
22.
Jeong S-H, Oh S-Y, Kim H-J et al (2010) Vestibular dysfunction in migraine: effects of associated vertigo and motion sickness. J Neurol 257:905–912PubMedCrossRef
23.
Versino M, Colagiorgio P, Sacco S et al (2014) Reading while moving: the functional assessment of VOR. J Vestib Res 24(5–6):459–464PubMedCrossRef
24.
25.
26.
Corallo G, Versino M, Mandalà M et al (2018) The functional head impulse test: preliminary data. J Neurol 265(Suppl 1):35–39PubMedCrossRef
27.
Doreen TV, Lucieer F, Duijin S et al (2019) The functional head impulse test to assess oscillopsia in bilateral vestibulopathy. Front Neurol 10:365CrossRef
28.
Sjögren J, Fransson PA, Karlberg M et al (2018) Functional head impulse testing might be useful for assessing vestibular compensation after unilateral vestibular loss. Front Neurol 9:979PubMedPubMedCentralCrossRef
29.
Watson AB, Pelli DG (1983) Quest: a Bayesian adaptive psychometric method. Percept Psychophys 33:113–120PubMedCrossRef
30.
Colnaghi S, Rezzani C, Gnesi M et al (2017) Validation of the Italian Version of the dizziness handicap inventory, the situational vertigo questionnaire, and the activity-specific balance confidence scale for peripheral and central vestibular symptoms. Front Neurol 8:528PubMedPubMedCentralCrossRef
31.
Wang J, Lewis RF (2016) Contribution of intravestibular sensory conflict to motion sickness and dizziness in migraine disorders. J Neurophysiol 116(4):1586–1591PubMedPubMedCentralCrossRef
32.
Lim Y-H, Kim J-S, Lee H-W, Kim S-H (2018) Postural instability induced by visual motion stimuli in patients with vestibular migraine. Front Neurol 9:433PubMedPubMedCentralCrossRef
33.
34.
Brandt T, Dieterich M (2019) Thalamocortical network: a core structure for integrative multimodal vestibular functions. Curr Opin Neurol 32:154–164PubMedCrossRef
35.
De Tommaso M, Ambrosini A, Brighina F et al (2014) Altered processing of sensory stimuli in patients with migraine. Nat Rev Neurol. 10:144–155PubMedCrossRef
36.
37.
Shin JH, Kim YK, Kim HJ, Kim JS (2014) Altered brain metabolism in vestibular migraine: comparison of interictal and ictal findings. Cephalalgia 34(1):58–67PubMedCrossRef
38.
Brandt T, Bartenstein P, Janek A, Dieterich M (1998) Reciprocal inhibitory visual-vestibular interaction. Visual motion stimulation deactivates the parieto-insular vestibular cortex. Brain 121(Pt 9):1749–1758PubMedCrossRef
39.
Messina R, Rocca MA, Colombo B et al (2017) Structural brain abnormalities in patients with vestibular migraine. J Neurol 264(2):295–303PubMedCrossRef
40.
Obermann M, Wurthmann S, Steinberg BS et al (2014) Central vestibular system modulation in vestibular migraine. Cephalalgia 34:1053–1061PubMedCrossRef
41.
Bense S, Stephan T, Yousry TA et al (2001) Multisensory cortical signal increases and decreases during vestibular galvanic stimulation (fMRI). J Neurophysiol 85(2):886–899PubMedCrossRef
42.
Deutschländer A, Bense S, Stephan T et al (2002) Sensory system interactions during simultaneous vestibular and visual stimulation in PET. Hum Brain Mapp 16(2):92–103PubMedPubMedCentralCrossRef
43.
Dieterich M, Bense S, Stephan T et al (2003) FMRI signal increases and decreases in cortical areas during small-field optokinetic stimulation and central fixation. Exp Brain Res 148(1):117–127PubMedCrossRef
44.
Bense S, Bartenstein P, Lochmann M et al (2004) Metabolic changes in vestibular and visual cortices in acute vestibular neuritis. Ann Neurol 56:624–630PubMedCrossRef
45.
Bense S, Stephan T, Bartenstein P et al (2005) Fixation suppression of optokinetic nystagmus modulates cortical visual-vestibular interaction. NeuroReport 16:887–890PubMedCrossRef
Metadata
Title
The integration of multisensory motion stimuli is impaired in vestibular migraine patients
Authors
Maurizio Versino
Marco Mandalà
Silvia Colnaghi
Giampietro Ricci
Mario Faralli
Stefano Ramat
Publication date
01-10-2020
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 10/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-09905-1

Other articles of this Issue 10/2020

Journal of Neurology 10/2020 Go to the issue

Original Communication

BOLD signal within and around white matter lesions distinguishes multiple sclerosis and non-specific white matter disease: a three-dimensional approach

Letter to the Editors

Brain hyper-excitability in DPPX ataxia

Review

Therapeutic effects of CPAP on cognitive impairments associated with OSA

Original Communication

Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis

Letter to the Editors

Onset of Covid-19 with impaired consciousness and ataxia: a case report

Letter to the Editors

Multifocal laminar cortical brain lesions: a consistent MRI finding in neuro-COVID-19 patients