Carvalho Gabriela F, Luedtke Kerstin, Pinheiro Carina F, Moraes Renato, Lemos Tenysson W, Bigal Marcelo E, Dach Fabiola, Bevilaqua-Grossi Debora
Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Department of Physiotherapy, Institute of Health Sciences, University of Luebeck, Luebeck, Germany.
Front Neurol. 2021 Nov 8;12:755990. doi: 10.3389/fneur.2021.755990. eCollection 2021.
It is evidenced that migraineurs present balance deficits. However, the balance recovery following unexpected ground perturbations, which reflect conditions of everyday activities, has not been investigated in this population. We aimed to assess the reactive postural responses among patients with migraine with and without aura, chronic migraine, and controls. We further aimed to assess the factors associated with greater self-report of falls. Ninety patients diagnosed by headache specialists were equally classified into three migraine subgroups according to the presence of aura and chronic migraine. Thirty controls were also recruited. All participants underwent the motor control test (MCT) and adaptation test (ADT) protocols of dynamic posturography tests (EquiTest®, NeuroCom, USA). Clinical and headache features and information on falls in the previous year, fear of falling, and vestibular symptoms were also assessed. Patients with aura presented a greater sway area in most of the MCT conditions than the other three groups ( = 0.001). The aura group also presented delayed latency responses after perturbations compared with controls and patients without aura ( < 0.03). In the ADT, a greater sway area was observed in patients with aura than in groups without aura, chronic migraine, and controls ( < 0.0001). The MCT and ADT sway area, the frequency of aura, and the fear of falling explained 46% of the falls in the previous 12 months. Patients with aura exhibited greater delay and sway area after unexpected ground perturbations than controls and other migraine subgroups, which are related to the reported number of falls.
有证据表明偏头痛患者存在平衡缺陷。然而，对于反映日常活动情况的意外地面扰动后的平衡恢复情况，尚未在该人群中进行研究。我们旨在评估有先兆和无先兆偏头痛患者、慢性偏头痛患者以及对照组的反应性姿势反应。我们还旨在评估与跌倒自我报告增加相关的因素。90名由头痛专家诊断的患者根据是否有先兆和慢性偏头痛情况被平均分为三个偏头痛亚组。还招募了30名对照组。所有参与者均接受了动态姿势描记测试（美国NeuroCom公司的EquiTest®）的运动控制测试（MCT）和适应测试（ADT）方案。还评估了临床和头痛特征以及上一年的跌倒信息、跌倒恐惧和前庭症状。有先兆偏头痛患者在大多数MCT条件下的摆动面积比其他三组更大（ = 0.001）。与对照组和无先兆偏头痛患者相比，有先兆偏头痛组在受到扰动后的潜伏期反应也延迟（ < 0.03）。在ADT中，有先兆偏头痛患者的摆动面积比无先兆偏头痛组、慢性偏头痛组和对照组更大（ < 0.0001）。MCT和ADT的摆动面积、先兆发作频率以及跌倒恐惧解释了前12个月内跌倒情况的46%。与对照组和其他偏头痛亚组相比，有先兆偏头痛患者在意外地面扰动后表现出更大的延迟和摆动面积，这与报告的跌倒次数有关。
