Mucci Viviana, Canceri Josephine M, Brown Rachael, Dai Mingjia, Yakushin Sergei B, Watson Shaun, Van Ombergen Angelique, Jacquemyn Yves, Fahey Paul, Van de Heyning Paul H, Wuyts Floris, Browne Cherylea J
Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
Front Neurol. 2018 May 24;9:362. doi: 10.3389/fneur.2018.00362. eCollection 2018.
Mal de Debarquement Syndrome (MdDS) is a condition characterized by a persistent perception of self-motion, in most cases triggered from exposure to passive motion (e.g., boat travel, a car ride, flights). Patients whose onset was triggered in this way are categorized as Motion-Triggered (MT) subtype or onset group. However, the same syndrome can occur spontaneously or after non-motion events, such as childbirth, high stress, surgery, etc. Patients who were triggered in this way are categorized as being of the Spontaneous/Other (SO) subtype or onset group. The underlying pathophysiology of MdDS is unknown and there has been some speculation that the two onset groups are separate entities. However, despite the differences in onset between the subtypes, symptoms are parallel and a significant female predominance has been shown. To date, the role of gonadal hormones in MdDS pathophysiology has not been investigated. This study aimed to evaluate the hormonal profile of MdDS patients, the presence of hormonal conditions, the influence of hormones on symptomatology and to assess possible hormonal differences between onset groups. In addition, the prevalence of migraine and motion sickness and their relation to MdDS were assessed.
Retrospective online surveys were performed in 370 MdDS patients from both onset groups. Data were analyzed using Fisher's exact test or Fisher-Freeman-Hanlon exact test. When possible, data were compared with normative statistical data from the wider literature.
From the data collected, it was evident that naturally cycling female respondents from the MT group were significantly more likely to report an aggravation of MdDS symptoms during menses and mid-cycle ( < 0.001). A few preliminary differences between the onset groups were highlighted such as in regular menstrual cycling ( = 0.028), reporting menses during onset ( < 0.016), and migraine susceptibility after onset ( = 0.044).
These results demonstrate a potential relation between hormone fluctuations and symptom aggravation in the MT group. This study is an important first step to suggest a hormonal involvement in the pathophysiology of MdDS and provides a base for further hormonal investigation. Future prospective studies should expand upon these results and explore the implications for treatment.
下船综合征（MdDS）是一种以持续自我运动感知为特征的病症，在大多数情况下，由暴露于被动运动（如乘船旅行、乘车、飞行）引发。以这种方式引发发病的患者被归类为运动触发（MT）亚型或发病组。然而，相同综合征也可能自发出现或在非运动事件后出现，如分娩、高压力、手术等。以这种方式引发发病的患者被归类为自发/其他（SO）亚型或发病组。MdDS的潜在病理生理学尚不清楚，有人推测这两个发病组是不同的实体。然而，尽管各亚型在发病方面存在差异，但症状相似，且已显示出女性明显占主导。迄今为止，性腺激素在MdDS病理生理学中的作用尚未得到研究。本研究旨在评估MdDS患者的激素水平、激素状况的存在、激素对症状的影响，并评估发病组之间可能存在的激素差异。此外，还评估了偏头痛和晕动病的患病率及其与MdDS的关系。
对来自两个发病组的370名MdDS患者进行了回顾性在线调查。使用Fisher精确检验或Fisher-Freeman-Hanlon精确检验对数据进行分析。如有可能，将数据与更广泛文献中的标准统计数据进行比较。
从收集的数据来看，很明显，MT组中自然月经周期正常的女性受访者在月经期间和月经周期中期更有可能报告MdDS症状加重（<0.001）。突出了发病组之间的一些初步差异，如规律月经周期（=0.028）、发病时报告月经（<0.016）以及发病后偏头痛易感性（=0.044）。
这些结果表明MT组中激素波动与症状加重之间存在潜在关系。本研究是表明激素参与MdDS病理生理学的重要第一步，并为进一步的激素研究提供了基础。未来的前瞻性研究应扩展这些结果并探索其对治疗的影响。
