Sharif Mishaal, Rea Oliver, Burling Rose, Ellul Miraval Mel, Patel Rakesh, Saman Yougan, Rea Peter, Yoon Ha-Jun, Kheradmand Amir, Arshad Qadeer
inAmind Laboratory, College of Life Sciences, University of Leicester, Leicester, United Kingdom.
Faculty of Health and Life Sciences, De Monfort University, Leicester, United Kingdom.
Front Neurol. 2024 Jul 25;15:1436127. doi: 10.3389/fneur.2024.1436127. eCollection 2024.
In this study, we examined whether vestibular migraine, as a source of increased perceptual uncertainty due to the associated dizziness, interferes with adaptive learning.
The IOWA gambling task (IGT) was used to assess adaptive learning in both healthy controls and patients with migraine-related dizziness. Participants were presented with four decks of cards (A, B, C, and D) and requested to select a card over 100 trials. Participants received a monetary reward or a penalty with equal probability when they selected a card. Card decks A and B (high-risk decks) involved high rewards (win £100) and high penalties (lose £250), whereas C and D (low-risk decks; favorable reward-to-punishment ratio) involved lower rewards (win £50) and penalties (lose £50). Task success required participants to decide (i.e., adaptively learn) through the feedback they received that C and D were the advantageous decks.
The study revealed that patients with vestibular migraine selected more high-risk cards than the control group. Chronic vestibular migraine patients showed delayed improvement in task performance than those with acute presentation. Only in acute vestibular migraine patients, we observed that impaired learning positively correlated with measures of dizzy symptoms.
The findings of this study have clinical implications for how vestibular migraine can affect behavioural adaption in patients, either directly through altered perception or indirectly by impacting cognitive processes that can result in maladaptive behavior.
在本研究中，我们探究了前庭性偏头痛作为因相关头晕导致感知不确定性增加的一个源头，是否会干扰适应性学习。
采用爱荷华赌博任务（IGT）来评估健康对照组和偏头痛相关性头晕患者的适应性学习。向参与者展示四副牌（A、B、C和D），并要求他们在100次试验中选择一张牌。参与者选牌时获得金钱奖励或惩罚的概率相等。A组和B组牌（高风险牌组）有高奖励（赢100英镑）和高惩罚（输250英镑），而C组和D组牌（低风险牌组；有利的奖惩比）有较低奖励（赢50英镑）和惩罚（输50英镑）。任务成功要求参与者通过他们收到的反馈来决定（即适应性学习）C组和D组牌是有利的牌组。
研究显示，前庭性偏头痛患者比对照组选择了更多高风险牌。慢性前庭性偏头痛患者在任务表现上的改善比急性发作患者延迟。仅在急性前庭性偏头痛患者中，我们观察到学习受损与头晕症状指标呈正相关。
本研究结果对于前庭性偏头痛如何影响患者的行为适应具有临床意义，其可能直接通过改变感知，或间接通过影响可导致适应不良行为的认知过程来实现。
