Vestibular migraine pathophysiology: insights from structural and functional neuroimaging

Tedeschi, Gioacchino; Russo, Antonio; Conte, Francesca; Marcuccio, Laura; Tessitore, Alessandro

doi:10.1007/s10072-015-2161-x

Cited by 24 publications

(14 citation statements)

References 24 publications

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“…Voxel-based morphometry studies found reductions in gray matter volumes in the inferior temporal gyrus, cingulate cortex, and posterior insula in patients with VM; these areas are involved in the cortical processing of vestibular and nociceptive information [77]. These functional and structural alterations in patients with VM resemble those previously described in patients with migraine; therefore, it is possible that VM represents a pathophysiological connection between migraine and the vestibular system [78]. …”

Section: Pathogenesis Of Vmmentioning

confidence: 83%

Recent Advances in the Understanding of Vestibular Migraine

Sohn

2016

Behavioural Neurology

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Approximately 1% of the general population and 10% of patients with migraine suffer from vestibular migraine (VM). However, this condition remains relatively unknown; therefore, it is often underdiagnosed despite the recent adoption of international diagnostic criteria for VM. The diagnosis of VM is based on the symptoms, degree, frequency, and duration of the vestibular episodes, a history of migraine, the temporal association of migraine symptoms with vestibular episodes in at least 50% of cases, and the exclusion of other causes. Physical examination and laboratory findings are usually normal in patients with VM but can be used to rule out other vestibular disorders with similar symptoms. The pathophysiology of VM remains incompletely understood; however, several mechanisms link the trigeminal system, which is activated during migraine attacks, and the vestibular system. Because few controlled trials have specifically investigated VM, the treatment options for this order are largely the same as those for migraine and include antiemetics for severe acute attacks, pharmacological migraine prophylaxis, and lifestyle changes.

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Section: Pathogenesis Of Vmmentioning

confidence: 83%

Recent Advances in the Understanding of Vestibular Migraine

Sohn

2016

Behavioural Neurology

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“…While performing research on either disorder, we must keep in mind that previous work was performed when VM was not fully recognized and that it was (and is) often difficult to distinguish between VM and MD such that patients may have been mislabeled and conclusions were drawn based on historical diagnostic criteria. It may be that we will not be able to make significant strides in understanding either disease until new technology allows for novel pathways of experimentation, but we have taken important steps in recent years such as the use of new MRI protocols to image migraine and ELH in MD [ 78 – 80 ]. We do not wish to dishearten physicians who treat patients with dizziness by suggesting that VM and MD are far too difficult currently to distinguish and properly diagnose.…”

Section: Reviewmentioning

confidence: 99%

The Intimate Relationship between Vestibular Migraine and Meniere Disease: A Review of Pathogenesis and Presentation

Liu

2016

Behavioural Neurology

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Vestibular migraine (VM) has only recently been recognized as a distinct disease entity. One reason is that its symptoms overlap greatly with those of other vestibular disorders, especially Meniere disease (MD). The pathophysiology of neither VM nor MD is entirely elucidated. However, there are many theories linking migraine to both disorders. We reviewed the current understanding of migraine, VM, and MD and described how VM and MD are similar or different from each other in terms of pathophysiology and presentation, including hypotheses that the two share a common etiology and/or are variants of the same disease.

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“…They hypothesized that subclinical vestibular dysfunction is a part of all migraine, not just vestibular migraine. Tedeschi et al reported on structural and functional neuroimaging work, highlighting evidence for abnormalities in multisensory vestibular control areas and in central vestibular processing . Russo et al presented evidence of abnormal thalamic function in response to vestibular stimulation in subjects with vestibular migraine .…”

Section: Discussion/observationsmentioning

confidence: 99%

Vestibular Neuroscience for the Headache Specialist

Balaban

Black²,

Silberstein

2019

Headache

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Background.-The vestibular system is a multifaceted, integrative sensory system that is often referred to as the "multi-sensory" sense. There is an extensive literature about the vestibular sensory organs and afferent nerve pathways; however, this rich resource is often unknown to the headache specialist.Aims.-In this review, we highlight the significance of vestibular sensory processing beyond its role in the maintenance of balance. The role of the vestibular system in migraine pathophysiology is emphasized, not just in how it impacts dizziness or nausea, but also in its higher order effects on mood and cognition. How the vestibular system responds to current and new migraine therapies, such as anti-CGRP (calcitonin gene-related peptide) antibodies, is also discussed.Conclusions.-The vestibular system is not just about balance; this should be taken into account by clinicians as they assess their patients' associated non-headache symptoms. There is a co-occurrence of migraine and vestibular-based problems and a confluence of disciplines relevant to vestibular migraine.Abbreviations: 5-HT receptors (5-hydroxytryptamine), (serotonin receptors) class of G protein coupled receptor and ligandgated ion channels. The subscript designations refer to specific receptor types, ATPase adenosine triphosphatase, an enzyme that catalyzes the hydrolysis or decomposition of ATP (adenosine triphosphate) into ADP (adenosine diphosphate) and a free phosphate ion, BOLD fMRI blood oxygen level-dependent functional magnetic resonance imaging, Cav2.1 voltage-dependent calcium channel, c-FOS protein that is often used as an indirect marker of neuronal activity, ICHD-3 International Classification of Headache Disorders, NaKA sodiumpotassium ATPase, SSRI selective serotonin reuptake inhibitor, Substance P neuropeptide that may affect vasodilation, inflammation, pain expression, and other regulated processes, TRPV1 transient receptor potential cation channel subfamily V, member 1, UCP2, 3 mitochondrial uncoupling protein 2 (or 3) HEADACHE CURRENTS Headache CurrentsHeadache Headache Currents mismatch") 20 can result in motion sickness, simulator sickness, and cybersickness. [21][22][23][24][25][26] Other somatic, non-vestibular signals that are involved in balance control and spatial orientation have been reviewed elsewhere 7 Since every tissue in the body has mass (including blood), linear acceleration (including gravity) alters sensory signals from baroreceptors, visceral pressure receptors, and somatic proprioceptors. These multiple sensory inputs simultaneously coordinate motor and autonomic responses during movement and changes in posture, particularly during unusual conditions (eg, swimming underwater). Vestibular Sensory PeripheryBody and head movements produce inertial and gravitational forces that are detected by vestibular sensory organs. 27 Since these organs are embedded in the temporal bone of the skull, the sensory information is "head-referenced." These organs are similar in structure in all vertebrates with jaws. 28 There are...

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Vestibular migraine pathophysiology: insights from structural and functional neuroimaging

Cited by 24 publications

References 24 publications

Recent Advances in the Understanding of Vestibular Migraine

Recent Advances in the Understanding of Vestibular Migraine

The Intimate Relationship between Vestibular Migraine and Meniere Disease: A Review of Pathogenesis and Presentation

Vestibular Neuroscience for the Headache Specialist

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