Subclinical vestibular dysfunction in migraineurs without vertigo: A Clinical study

Bernetti, Laura; Pellegrino, Cristina; Corbelli, Ilenia; Caproni, Stefano; Faralli, Mario; Ricci, Giampietro; Calabresi, Paolo; Sarchielli, Paola

doi:10.1111/ane.12941

Cited by 16 publications

(18 citation statements)

References 32 publications

(90 reference statements)

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“…These purkinje cells are inhibitory to the fastigial output nucleus, allowing the medial cerebellum to exert an inhibitory modulating in uence on the vestibular system [28][29] [30]. A state of vestibular hyperactivity may be facilitated by even slight, subclinical, diminished inhibition by the cerebellum [13]. Consequently, aberrant proprioceptive tra c into the vestibular system and the medial cerebellum arising from tight sub-occipital musculature, possibly aquired at birth [5], could conceivably provide a mechanism for dysregulation and hyperactivity of the vestibular nuclei.…”

Section: Discussionmentioning

confidence: 99%

“…In concordance with their central role in many regulatory processes the vestibular nuclei have extensive projections to other brainstem nuclei [30]. This means that any vestibular dysregulation present may well be propagated to those same brainstem nuclei, particulary of the autonomic system [13], leading to a spectre of associated symptoms such as listed in the introduction.…”

Section: Discussionmentioning

confidence: 99%

“…The index was developed in our chiropractic clinic where it has been utilized for over three years. Mild rhythmic vestibular stimulation is known to have a relaxing, soothing effect [12], whereas vestibular overstimulation tends to be unconfortable and may lead to dizziness, nausea or even vomitting [13].…”

Section: Clinical Index Of Vestibular (Hyper)activitymentioning

confidence: 99%

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Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Compared to Non-Colicky Babies.

Hoeve¹

2020

Preprint

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Aim: to present a five-point clinical index of vestibular (hyper)activity and its application as a tool to investigate vestibular dysregulation in colicky and non-colicky babies.Methods: 120 consecutive colicky babies, before and after treatment, were evaluated using this index and compared to 117 non-colicky babies.Results. Before treatment out of 120 colicky babies 118 (98.3%) scored 1-5 and only 2 (1.7%) scored 0. Out of 117 non-colicky babies 89 (76,1%) scored 0 and 28 (23.9%) scored 1-3, none scored 4-5. Odds ratios are OR (CI 95%) 187.54 (43.52-808.09). After treatment 111 (92.5%) scored 0 and 9 (7.5%) scored 1-3, none scored 4-5. A McNemar test showed the difference before and after to be significant (χ² = 109.00, p < .001). For colicky babies the mean vestibular score is 2.88(SD 1.22), compared to 0.37(SD 0.73) for non-colicky babies, a difference of 87.2%. After treatment the score decreased from 2.88 (SD 1.12) to 0.10 (SD 0.40), or 96.5%. Conclusion: colicky babies are not just infants who cry a lot. They also show clinical evidence of vestibular dysregulation. The vestibular index opens the prospect that it could be developed into a tool towards an objective clinical diagnosis of infantile colic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Compared to Non-Colicky Babies.

Hoeve¹

2020

Preprint

View full text Add to dashboard Cite

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“…In concordance with their central role in many regulatory processes the vestibular nuclei have extensive projections to other brainstem nuclei [30]. This means that any vestibular dysregulation present may well be propagated to those nuclei, particulary of the autonomic system [13], leading to a spectrum of associated symptoms such as listed in the introduction.…”

Section: Discussionmentioning

confidence: 99%

“…The index was developed in our chiropractic clinic where it has been utilized for over three years. Mild rhythmic vestibular stimulation is known to have a relaxing, soothing effect [12], whereas vestibular overstimulation tends to be uncomfortable and may lead to dizziness, nausea or even vomitting [13].…”

Section: Clinical Index Of Vestibular (Hyper)activitymentioning

confidence: 99%

Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Versus Non-Colicky Babies.

Hoeve¹

2020

Preprint

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BackgroundAfter 65 years of research that has been primarily directed at differentiating between normal and colicky crying, the cause of infantile colic remains elusive and no definitive cure has been found. Given the general absence of pathology, colicky crying is widely considered the extreme end of a spectrum of normal crying behavior. In the literature scattered evidence can be found suggesting that infantile colic may be the behavioral expression of physiological brainstem dysregulation, particularly of the vestibular and autonomic nuclei. The purpose of this study is to present a five-point clinical index of vestibular (hyper)activity and its application to investigate vestibular dysregulation in colicky and non-colicky babies.Methods120 consecutive colicky babies were evaluated using this index, before and after a very gentle vibratory treatment, and compared to 117 non-colicky babies.ResultsBefore treatment, of 120 colicky babies only 2 (1.7%) scored 0, whereas 118 (98.3%) scored scored 1-5. Of 117 non-colicky babies 89 (76,1%) scored 0 and 28 (23.9%) scored 1-3, none scored 4-5. The odds ratio is OR (CI 95%) 187.54 (43.52-808.09). After treatment 111 (92.5%) scored 0 and 9 (7.5%) scored 1-3, none scored 4-5. A McNemar test showed the difference before and after to be significant (χ² = 109.00, p < .001). For colicky babies the mean vestibular score is 2.88(SD 1.22), compared to 0.37(SD 0.73) for non-colicky babies, a difference of 87.2%. After treatment the score decreased from 2.88 (SD 1.12) to 0.10 (SD 0.40), or 96.5%. ConclusionColicky babies are not just infants who cry a lot. They also show clinical evidence of vestibular dysregulation. Gentle treatment aimed at relaxing tight sub-occipital musculature by means of a vibrational technique may be effective in decreasing vestibular hyperactivity, signifying an improvement in brainstem regulation. The vestibular index opens the prospect for development into a tool towards an objective and practical clinical diagnosis of infantile colic.

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vHIT and fHIT in Patients With Migraine, Vestibular Migraine, and Persistent Postural‐Perceptual Dizziness

Kirazli,

Balayeva,

Kacan Yilmaz

et al. 2024

The Laryngoscope

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ObjectiveImpairment in the integration of different vestibular stimuli is the proposed mechanisms in vestibular migraine (VM). In this study, it was aimed to assess the vestibulo‐ocular reflex (VOR) and dynamic visual acuity (DVA) in patients with VM and to compare the results with migraine without vestibular symptoms (MwoV), and persistent postural‐perceptual dizziness (PPPD) to find out if there are discriminative differences and search for a correlation with the levels of anxiety.MethodsTwenty‐two patients with MwoV, 23 patients with VM, 22 patients with PPPD, and 23 healthy controls (HC) were studied. Video head impulse test (vHIT) and functional head impulse test (fHIT) without and with an optokinetic background (OB) were performed. Percentage of correctly identified optotypes (CA%) was considered for the fHIT test. Beck anxiety inventory (BAI) was used to assess anxiety.ResultsLateral canal vHIT gain of the patient groups were not different from the healthy controls (p > 0.05). fHIT and fHIT/OB CA% results of all patient groups were lower than the HC (p < 0.005), and VM patients had the lowest scores for both tests. BAI scores of the PPPD patients were the highest and a correlation between anxiety levels, and fHIT results could not be identified (p > 0.05).ConclusionProminent CA% drop by the use of an OB was the main finding in patients with VM. This discriminative feature was not correlated with anxiety scores. Difficulty in resolving the conflict between visual and vestibular inputs seem to be the underlying mechanism.Level of Evidence3 Laryngoscope, 2024

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Subclinical vestibular dysfunction in migraineurs without vertigo: A Clinical study

Abstract: Our findings suggest a subclinical alteration of vestibular pathway in migraineurs who have never complained vertigo or postural imbalance. This finding supports the hypothesis of a vestibular-cerebellar dysfunction in migraineurs, particularly among those with aura.

Cited by 16 publications

References 32 publications

Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Compared to Non-Colicky Babies.

Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Compared to Non-Colicky Babies.

Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Versus Non-Colicky Babies.

vHIT and fHIT in Patients With Migraine, Vestibular Migraine, and Persistent Postural‐Perceptual Dizziness

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