Department of Otology, Harvard Medical School, Boston MA, USA.
J Vestib Res. 2011;21(6):323-30. doi: 10.3233/VES-2011-0422.
Vestibular symptoms caused by migraine, referred to as vestibular migraine, are a frequently diagnosed but poorly understood entity. Based on recent evidence that normal subjects generate vestibular-mediated percepts of head motion and reflexive eye movements using different mechanisms, we hypothesized that percepts of head motion may be abnormal in vestibular migraine. We therefore measured motion detection thresholds in patients with vestibular migraine, migraine patients with no history of vestibular symptoms, and normal subjects using the following paradigms: roll rotation while supine (dynamically activating the semicircular canals); quasi-static roll tilt (statically activating the otolith organs); and dynamic roll tilt (dynamically activating the canals and otoliths). Thresholds were determined while patients were asymptomatic using a staircase paradigm, whereby the peak acceleration of the motion was decreased or increased based on correct or incorrect reports of movement direction. We found a dramatic reduction in motion thresholds in vestibular migraine compared to normal and migraine subjects in the dynamic roll tilt paradigm, but normal thresholds in the roll rotation and quasi-static roll tilt paradigms. These results suggest that patients with vestibular migraine may have enhanced perceptual sensitivity (e.g. increased signal-to-noise ratio) for head motions that dynamically modulate canal and otolith inputs together.
偏头痛引起的前庭症状，称为前庭性偏头痛，是一种经常被诊断但了解甚少的病症。基于最近的证据表明，正常受试者使用不同的机制产生前庭介导的头部运动知觉和反射性眼球运动，我们假设前庭性偏头痛患者的头部运动知觉可能异常。因此，我们使用以下范式测量了前庭性偏头痛患者、无前庭症状偏头痛患者和正常受试者的运动检测阈值：仰卧位时的滚动旋转（动态激活半规管）；准静态滚动倾斜（静态激活耳石器）；和动态滚动倾斜（动态激活管和耳石器）。使用阶梯范式在患者无症状时确定阈值，其中运动的峰值加速度根据运动方向的正确或错误报告而降低或增加。我们发现，与正常和偏头痛受试者相比，前庭性偏头痛患者在动态滚动倾斜范式中的运动阈值显著降低，但在滚动旋转和准静态滚动倾斜范式中的阈值正常。这些结果表明，前庭性偏头痛患者可能对同时动态调节管和耳石器输入的头部运动具有增强的知觉敏感性（例如，增加信噪比）。
