Kim Chul-Ho, Jang Min-Uk, Choi Hui-Chul, Sohn Jong-Hee
Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 153 Gyo-dong, Chuncheon-si, Gangwon-do, 200-704, Republic of Korea.
J Headache Pain. 2015;16:93. doi: 10.1186/s10194-015-0578-5. Epub 2015 Nov 2.
Many studies have identified various vestibular symptoms and laboratory abnormalities in migraineurs. Although the vestibular tests may be abnormal, the changes may exist without vestibular symptoms. To date, vestibular-evoked myogenic potential (VEMP) has been the easiest and simplest test for measuring vestibular function in clinical practice. Cervical VEMP (cVEMP) represents a vestibulo-collic reflex, whereas ocular VEMP (oVEMP) reflects a vestibulo-ocular pathway. Therefore, we determined whether ocular and rectified cervical VEMPs differed in patients with migraine or tension type headache (TTH) and compared the results to controls with no accompanying vestibular symptoms.
The present study included 38 females with migraine without aura, 30 with episodic TTH, and 50 healthy controls without vestibular symptoms. oVEMP and cVEMP using a blood pressure manometer were recorded during a headache-free period. From the VEMP graphs, latency and amplitude parameters were analyzed, especially following EMG rectification in cVEMP.
With respect to oVEMP, the migraine group exhibited significantly longer mean latencies of bilateral n1 and left p1 than the other groups (p < 0.05). Amplitudes of n1-p1 were lower than in other groups, but the difference did not reach statistical significance. In regards to cVEMP, p13 and n23 latencies and amplitudes after rectification did not differ significantly among groups.
An abnormal interictal oVEMP profile was associated with subclinical vestibular dysfunction in migraineurs, suggesting pathology within the vestibulo-ocular reflex. oVEMP is a more reliable measure than cVEMP to evaluate vestibular function in migraineurs, although results from the two tests in patients with migraine are complementary.
许多研究已在偏头痛患者中识别出各种前庭症状和实验室异常。尽管前庭测试可能异常，但这些变化可能在没有前庭症状的情况下存在。迄今为止，前庭诱发肌源性电位（VEMP）一直是临床实践中测量前庭功能最简单易行的测试。颈性VEMP（cVEMP）代表前庭-颈反射，而眼性VEMP（oVEMP）反映前庭-眼通路。因此，我们确定偏头痛或紧张型头痛（TTH）患者的眼性和校正后的颈性VEMP是否存在差异，并将结果与没有伴随前庭症状的对照组进行比较。
本研究纳入了38名无先兆偏头痛女性、30名发作性TTH患者以及50名无前庭症状的健康对照者。在无头痛期间记录使用血压计进行的oVEMP和cVEMP。从VEMP图中分析潜伏期和振幅参数，特别是cVEMP经肌电图校正后的参数。
关于oVEMP，偏头痛组双侧n1和左侧p1的平均潜伏期明显长于其他组（p < 0.05）。n1-p1的振幅低于其他组，但差异未达到统计学意义。关于cVEMP，校正后的p13和n23潜伏期及振幅在各组之间无显著差异。
发作间期oVEMP异常与偏头痛患者的亚临床前庭功能障碍相关，提示在前庭-眼反射存在病变。oVEMP比cVEMP更可靠地评估偏头痛患者的前庭功能，尽管偏头痛患者这两项测试的结果是互补的。
