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梅尼埃病与前庭性偏头痛之间的关联。

Association between Ménière's disease and vestibular migraine.

作者信息

Pyykkö Ilmari, Manchaiah Vinaya, Färkkilä Markus, Kentala Erna, Zou Jing

机构信息

Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland. Electronic address: http://ilmari.pyykkotuni.fi.

Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, United States; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India; Audiology India, Mysore, Karnataka, India.

出版信息

Auris Nasus Larynx. 2019 Oct;46(5):724-733. doi: 10.1016/j.anl.2019.02.002. Epub 2019 May 1.

Abstract

OBJECTIVE

The aim of the present study was to evaluate complaints in people with Ménière's disease (MD) with and without migraine and headache to study the association between MD and Vestibular Migraine (VM). We believe this will help us understand if these two disorders represent a disease continuum in that they may share a common aetiology.

METHODS

The study used a retrospective design and included data of 911 patients with MD from the Finnish Ménière Federation database. The study participants had a mean age of 60.2 years, mean duration of disease of 12.6 years, and 78.7% of the participants were females. The questionnaire data comprised of both disease specific and impact related questions. The data were analyzed using the Mann-Whitney U test, the Kruskal Wallis H test, logistic regression analyses, and decision tree analysis.

RESULTS

Migraine and headache was reported by 190 subjects (20.9%) and 391 subjects (42.9%) respectively. We found that patients that could be classified as VM in the study (i.e., those with frequent vertigo spells associated with migraine) more often reported complaints of severe MD symptoms, had reduced health-related quality of life, suffered more from anxiety, had more neurological complaints, and experienced a reduced sense of coherence than the non-migraneous patients with MD. However, neither the decision tree analysis nor the logistic regression analysis could reliably discriminate VM from MD patients.

CONCLUSION

Our study results confirm that MD is frequently associated with headache and migraine. In addition, results also indicate that migraine provokes the severity of MD. We suggest that MD and VM may share similar pathophysiological mechanisms. Hence, the future MD classification systems should include a category referred to as 'MD with migraine' that will include patients with VM.

摘要

目的

本研究旨在评估伴有和不伴有偏头痛及头痛的梅尼埃病(MD)患者的主诉,以研究MD与前庭性偏头痛(VM)之间的关联。我们认为这将有助于我们了解这两种疾病是否代表一种疾病连续体,因为它们可能有共同的病因。

方法

本研究采用回顾性设计,纳入了芬兰梅尼埃病联盟数据库中911例MD患者的数据。研究参与者的平均年龄为60.2岁,平均病程为12.6年,78.7%的参与者为女性。问卷数据包括疾病特异性问题和影响相关问题。使用曼-惠特尼U检验、克鲁斯卡尔-沃利斯H检验、逻辑回归分析和决策树分析对数据进行分析。

结果

分别有190名受试者(20.9%)和391名受试者(42.9%)报告有偏头痛和头痛。我们发现,在研究中可归类为VM的患者(即那些伴有与偏头痛相关的频繁眩晕发作的患者)比无偏头痛的MD患者更常报告严重的MD症状、健康相关生活质量下降、焦虑更严重、神经学主诉更多以及连贯感降低。然而,决策树分析和逻辑回归分析均不能可靠地将VM与MD患者区分开来。

结论

我们的研究结果证实MD常与头痛和偏头痛相关。此外,结果还表明偏头痛会加重MD的严重程度。我们建议MD和VM可能有相似的病理生理机制。因此,未来的MD分类系统应包括一个称为“伴有偏头痛的MD”的类别,其中将包括VM患者。

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