Factors determining the response to treatment in patients with vestibular migraine

Ak, Ayşın Kısabay; Çelebisoy, Neşe; Özdemir, Hüseyin Nezih; Gökçay, Figen; Durmaz, Gülsüm Saruhan; Karti, Dilek Top; Toydemir, Hülya Ertaşoğlu; Yayla, Vildan; Işıkay, Ayşe İlksen Çolpak; Erkent, Irem; Özçelik, Pınar; Akdal, Gülden; Ataç, Ceyla; Bıçakçı, Şebnem; Ozaydın-Göksu, Eylem; Uyaroğlu, Feray Güleç

doi:10.1080/01616412.2022.2056341

Cited by 7 publications

(8 citation statements)

References 51 publications

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“…In recent years, comorbid psychological and physical symptoms in vertigo patients has gained interest among clinicians. The coexistence of vestibular and psychiatric disorders has been repeatedly described in the literature (Best et al, 2009;Lahmann et al, 2015;Limburg et al, 2018;Bronstein and Dieterich, 2019;Toupet et al, 2019;Özdilek et al, 2019;Kısabay Ak et al, 2022), with anxiety and depression cited as the primary factors. Many Influence of age, gender, anxiety, and depression on vertigo degree.…”

Section: Discussionmentioning

confidence: 97%

The effect of accompanying anxiety and depression on patients with different vestibular syndromes

Feng

Shi

2023

Front. Aging Neurosci.

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ObjectiveThis study aims to investigate the situation of vertigo disorder combined with anxiety and depression in patients with different types of vestibular syndrome.MethodsA total of 330 patients with vertigo in otolaryngology outpatient department were selected, and clinical information such as age, gender, and scores of Dizziness handicap inventory (DHI), Generalized anxiety disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) were collected. Analyzed the differences among acute vestibular syndrome (AVS), episodic vestibular syndrome (EVS) and chronic vestibular syndrome (CVS) in terms of age, gender, comorbid anxiety and depression, and the multivariate ordered logistic regression analysis was used to evaluate the relationship between the above factors and the degree of vertigo disorder.ResultsThe three types of vestibular syndrome had no significant difference in age composition, sex composition, anxiety and depression. There was no significant difference in the probability of anxiety and depression among vertigo patients of different ages and genders. The total score of vertigo disorder and each sub-item score were higher in patients with anxiety and depression. Patients with anxiety mainly manifested in EVS and CVS, while patients with depression mainly manifested in EVS and AVS. The probability of increased vertigo in anxious patients was 4.65 times that of non-anxious patients, and the probability of increased vertigo in depressed patients was 3.49 times that of non-depressed patients. Age and gender had no statistically significant effect on the degree of vertigo. In patients with EVS, anxiety and depression had a significant effect on the degree of vertigo; in patients with CVS, anxiety had a significant effect on the degree of vertigo, but depression had no significant effect.ConclusionAge and gender do not significantly affect the degree of vertigo disorder and mental state in various vestibular syndromes. Instead, anxiety and depression are the risk factors for aggravating the degree of vertigo disorder, and manifest differently in each type of vestibular syndrome. Therefore, it is necessary to use a quick scale tool to conduct a standardized screening of the psychological status of patients with vertigo.

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Section: Discussionmentioning

confidence: 97%

The effect of accompanying anxiety and depression on patients with different vestibular syndromes

Feng

Shi

2023

Front. Aging Neurosci.

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“…There may be a relationship between VM and Méniere disease (MD) [ 202 ]. Aural fullness may be an anamnestic key to differentiate VM from MD [ 203 ]. Patients with VM may have a high incidence of endolymphatic hydrops, although smaller than that of MD [ 204 ]; however, no anatomical differences were found between VM patients and healthy subjects with 3D-SPACE MRI [ 205 ].…”

Section: Neuro-otological Manifestationsmentioning

confidence: 99%

“…Recently, the inhibition of CGRP receptors has been shown to improve the vestibular function in animal models of chronic migraines [ 228 ], and retrospective studies in humans show a potential benefit when targeting the CGRP pathway [ 229 ]. Half of the patients were reported to respond to one prophylactic, 17% responded to a combination of two, and 10% did not have a response [ 203 ]. Predictors of poor response have been reported to be female sex, interictal imbalance, anxiety or depression, and our next topic, cutaneous allodynia [ 203 ].…”

Section: Neuro-otological Manifestationsmentioning

confidence: 99%

“…Half of the patients were reported to respond to one prophylactic, 17% responded to a combination of two, and 10% did not have a response [ 203 ]. Predictors of poor response have been reported to be female sex, interictal imbalance, anxiety or depression, and our next topic, cutaneous allodynia [ 203 ].…”

Section: Neuro-otological Manifestationsmentioning

confidence: 99%

“…Pathophysiology : The mechanisms that predispose a patient to allodynia may represent a risk for other forms of sensory dysfunction [ 164 , 203 ]. Migraineurs have, in general, lower pressure-pain and heat thresholds than the general population [ 232 ].…”

Section: Neuro-otological Manifestationsmentioning

confidence: 99%

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Pathophysiology and Therapy of Associated Features of Migraine

Villar-Martínez

Goadsby

2022

Cells

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Migraine is a complex and debilitating disorder that is broadly recognised by its characteristic headache. However, given the wide array of clinical presentations in migraineurs, the headache might not represent the main troublesome symptom and it can even go unnoticed. Understanding migraines exclusively as a pain process is simplistic and certainly hinders management. We describe the mechanisms behind some of the most disabling associated symptoms of migraine, including the relationship between the central and peripheral processes that take part in nausea, osmophobia, phonophobia, vertigo and allodynia. The rationale for the efficacy of the current therapeutic arsenal is also depicted in this article. The associated symptoms to migraine, apart from the painful component, are frequent, under-recognised and can be more deleterious than the headache itself. The clinical anamnesis of a headache patient should enquire about the associated symptoms, and treatment should be considered and individualised. Acknowledging the associated symptoms as a fundamental part of migraine has permitted a deeper and more coherent comprehension of the pathophysiology of migraine.

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Neurological update: neuro-otology 2023

Halmágyi,

Akdal,

Welgampola

et al. 2023

J Neurol

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Much has changed since our last review of recent advances in neuro-otology 7 years ago. Unfortunately there are still not many practising neuro-otologists, so that most patients with vestibular problems need, in the first instance, to be evaluated and treated by neurologists whose special expertise is not neuro-otology. The areas we consider here are mostly those that almost any neurologist should be able to start managing: acute spontaneous vertigo in the Emergency Room—is it vestibular neuritis or posterior circulation stroke; recurrent spontaneous vertigo in the office—is it vestibular migraine or Meniere's disease and the most common vestibular problem of all—benign positional vertigo. Finally we consider the future: long-term vestibular monitoring and the impact of machine learning on vestibular diagnosis.

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Factors determining the response to treatment in patients with vestibular migraine

Cited by 7 publications

References 51 publications

The effect of accompanying anxiety and depression on patients with different vestibular syndromes

The effect of accompanying anxiety and depression on patients with different vestibular syndromes

Pathophysiology and Therapy of Associated Features of Migraine

Neurological update: neuro-otology 2023

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