Outcome of vestibular rehabilitation in vestibular migraine

Balci, Birgül; Akdal, Gülden

doi:10.1007/s00415-022-11250-4

Cited by 7 publications

(4 citation statements)

References 47 publications

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“…Meanwhile, the study evaluating the efficacy using VADL improvement in peripheral vestibular disorders was sparse (30). The effect of vestibular rehabilitation for central vestibular disorders, such as stroke, traumatic brain injury, persistent postural-perceptual dizziness, and vestibular migraine, has also been tested (8,9,(12)(13)(14)(15)31). The results were promising, but more robust evidence needs to be supplemented.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been adopted for patients with persistent postural-perceptual dizziness or other functional dizziness (1,10,11). The efficacy is also being reported in vestibular migraine and other central vestibular disorders (12)(13)(14)(15). What is known more is that vestibular rehabilitation is effective regardless of patients' age, symptom duration and intensity, but is more effective when patients do not have psychological distress such as anxiety and depression (2,(16)(17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 98%

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Efficacy of vestibular rehabilitation and its facilitating and hindering factors from real-world clinical data

Kim,

Yun,

Lee

et al. 2024

Front. Neurol.

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Background and purposeCustomized vestibular rehabilitation improved dizziness and imbalance in several randomized controlled trials. In the present study, we determined the efficacy of customized vestibular rehabilitation using real-world observational data.MethodsIn this retrospective observational study, we recruited 64 patients (median age = 60, interquartile range = 48–66.3) who completed the customized vestibular rehabilitation from January to December 2022. The outcomes of rehabilitation were evaluated using the dizziness handicap inventory (DHI) or vestibular disorders activities of daily living scale (VADL). The factors associated with outcomes were assessed with a generalized linear model, of which covariates included patients’ age, sex, duration of illness, type of vestibular disorders, initial DHI and VADL scores, exercise compliance, and initial hospital anxiety and depression scale (HADS) scores.ResultsAfter the median of 6 (4–6) weeks of rehabilitation, DHI and VADL scores significantly improved in patients with either peripheral or central vestibular disorders (Wilcoxon signed-rank test, p < 0.05). The initial DHI and VADL scores showed a positive while the sum of HADS scores showed a negative correlation with the outcome. In contrast, the age, sex, duration of illness, types of vestibular disorders, and exercise compliance did not affect the outcome.Discussion and conclusionCustomized vestibular rehabilitation is effective for central as well as peripheral disorders, especially when the symptoms are severe and the psychological distress is mild.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Efficacy of vestibular rehabilitation and its facilitating and hindering factors from real-world clinical data

Kim,

Yun,

Lee

et al. 2024

Front. Neurol.

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“…It has been validated in cases of acute [ 25 ] and recurrent [ 26 ] vestibular disorders, as well as chronic dizziness [ 27 ]. Elevated DHI scores have been documented in VM patients [ 28 ], and the questionnaire has been employed to examine the effects of personalized vestibular rehabilitation (VR) programs on balance, gait performance, and self-perceived handicap in VM patient groups [ 29 ]. Moreover, the objective testing performed in our study (i.e., videonystagmography findings) significantly improved after anti-CGRP mAbs, with pathological signs dropping from 48% pre-treatment to 4% after-treatment ( p = 0.002).…”

Section: Discussionmentioning

confidence: 99%

Monoclonal Antibodies Targeting CGRP: A Novel Treatment in Vestibular Migraine

Lovato,

Disco,

Frosolini

et al. 2023

Medicina

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Background. Monoclonal antibodies (mAbs) directed against the calcitonin gene-related peptide (CGRP) or its receptor represented the first targeted and specialized approach to migraine prophylaxis. Nevertheless, they have been rarely considered in the treatment of vestibular migraine (VM). Our aim was to evaluate the effectiveness of anti-CGRP mAbs in VM patients who did not respond to conventional migraine treatments. Methods. Consecutive VM patients treated with erenumab were considered. As a comparison, we considered the same VM patients during conventional migraine treatments (i.e., propranolol, flunarizine, or valproic acid), which were tried before mAbs therapy. Videonystagmography, the Italian version of the Dizziness Handicap Inventory (DHI) questionnaire, and migraine days over the last 3 months were evaluated in all patients before and after treatments. Results. In the present retrospective study, we included 21 female and 2 male VM patients, mean age 45.2 years. All patients underwent contrast-enhanced magnetic resonance imaging that ruled out other causes of vertigo. The DHI questionnaire significantly improved after mAb therapy (p < 0.0001). Mean migraine days over the last 3 months were significantly reduced after treatment (p = 0.001). Videonystagmography was altered in 11 (48%) patients prior to monoclonal antibodies. We found vertical positional nystagmus in 9 patients and horizontal positional nystagmus in 2 patients. After the treatment, we found vertical positional nystagmus only in 1 patient (p = 0.002). When patients were treated with conventional therapies, there was no significant reduction in DHI, and instrumental vestibular examinations remained altered. Conclusions. VM patients using anti-CGRP mAbs experienced a reduction in the dizziness-derived handicap, as reported in the DHI questionnaire. Furthermore, these treatments were significantly associated with a normalization of vestibular instrumental analysis. These findings were not seen with conventional treatments. Treatment with anti-CGRP mAbs may be effective in VM patients who did not respond to conventional migraine treatments. These findings should be tested in large, randomized clinical trials.

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“…Важную роль играют минимизация провоцирующих факторов, избегание как недосыпания, так и пересыпания, а также пищевых триггеров, регулярная физическая активность [7,60]. Вестибулярная реабилитация включает упражнения на устойчивость взгляда и привыкание, тренировку ходьбы и равновесия; могут быть эффективны занятия танцами и настольным теннисом [61][62][63]. Пациентам с редкими и нетяжелыми приступами достаточно объяснения природы заболевания и его доброкачественного характера.…”

Section: Diagnostic Criteria For Vm According To the International Cl...unclassified

Vestibular migraine: epidemiology, pathogenesis, clinical picture, diagnosis and treatment

Кулеш

Parfenov

2022

RJTAO

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В ежедневной амбулаторной и неотложной клинической практике врач-невролог часто сталкивается с головокружением, которое характеризуется полиморфной клинической картиной, непредсказуемым течением и не соответствует критериям частых причин вестибулярных нарушений -доброкачественного позиционного головокружения (ДППГ) и вестибулярногого нейронита [1][2][3]. Более того, в течении, казалось бы, установленного заболевания (вертебробазилярный инсульт, вестибулярный нейронит, ДППГ) нередко прослеживаются нетипичные черты, которые заставляют заподозрить другой диагноз. Тщательный сбор анамнеза зачастую позволяет выявить у этих пациентов мигрень. Коморбидность мигрени и головокружения известна давно, однако интерес к проблеме вестибулярной мигрени (ВМ) резко возрос в последние два десятилетия. Благодаря работам T.

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Outcome of vestibular rehabilitation in vestibular migraine

Cited by 7 publications

References 47 publications

Efficacy of vestibular rehabilitation and its facilitating and hindering factors from real-world clinical data

Efficacy of vestibular rehabilitation and its facilitating and hindering factors from real-world clinical data

Monoclonal Antibodies Targeting CGRP: A Novel Treatment in Vestibular Migraine

Vestibular migraine: epidemiology, pathogenesis, clinical picture, diagnosis and treatment

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