Department of Neurology, Eginition Hospital, University of Athens, Athens, Greece.
Eur J Neurol. 2019 Feb;26(2):319-e21. doi: 10.1111/ene.13815. Epub 2018 Oct 26.
Migraine has long been associated with unsteadiness and dizziness but postural control has not been studied in the ictal state. Here, the stability of upright stance during migraine attacks was measured.
Static balance was assessed prospectively in migraine patients (n = 30) during quiet stance for 40 s on a posturographic force platform. Recordings were performed both ictally and in the pain-free interval. Subjects were assessed under four different conditions yielding different visual and proprioceptive feedback environments. Both ictal and interictal data were compared with age-matched healthy controls (n = 30).
Postural instability increased significantly under all experimental conditions during migraine attacks. Whilst standing on a foam pad with eyes closed, median sway area was 353 mm in control subjects, 318 mm in migraineurs in the pain-free period and 618 mm in the ictal state. However, Romberg and vestibular Romberg quotients were not altered during migraine attacks. Spectral analyses of postural sway also showed similar profiles in migraineurs and controls. The severity of headache was inversely correlated to Romberg quotients.
The demonstrated pattern of balance disorder during migraine attacks suggests a transient cerebellar dysfunction. Our findings also indicate that intense headache induces a re-weighting of sensory processing toward less dependence on visual and proprioceptive information.
偏头痛长期以来与不稳定和头晕有关，但在发作期尚未研究过姿势控制。在此，测量了偏头痛发作期间直立姿势的稳定性。
前瞻性地在偏头痛患者（n=30）中评估了在姿势描记力平台上安静站立 40 秒时的静态平衡。在发作期和无疼痛间隔期进行记录。根据不同的视觉和本体感觉反馈环境，对受试者进行了四种不同条件下的评估。将发作期和发作间期的数据与年龄匹配的健康对照组（n=30）进行比较。
在偏头痛发作期间，所有实验条件下的姿势不稳定都显著增加。在闭眼站在泡沫垫上时，对照组的中位摇摆面积为 353mm，偏头痛患者在无疼痛期为 318mm，发作期为 618mm。然而，在偏头痛发作期间，Romberg 和前庭 Romberg 比值没有改变。姿势摇摆的频谱分析也显示了偏头痛患者和对照组相似的模式。头痛的严重程度与 Romberg 比值呈负相关。
偏头痛发作期间平衡障碍的表现模式表明存在短暂的小脑功能障碍。我们的发现还表明，剧烈的头痛会引起对视觉和本体感觉信息的依赖减少的感觉处理重新加权。
