Sharifi Alireza, Kouhi Ali, Steenerson Kristen K, Sharon Jeffrey D
Department of Otolaryngology Head and Neck Surgery, Amir A'lam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Headache. 2025 Mar;65(3):521-526. doi: 10.1111/head.14866. Epub 2024 Dec 30.
Vestibular migraine (VM) has a wide range of clinical presentations that can have a significant negative impact on quality of life. Currently, there is no objective test available to confirm the diagnosis or measure the severity of VM. The only available tools for assessing disease severity are patient-reported outcome measures (PROMs), such as the Dizziness Handicap Inventory (DHI).
This manuscript aims to summarize the current knowledge about a newly developed PROM called the Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI).
A comprehensive search was conducted across the Web of Science, Scopus, PubMed, and Google Scholar databases up to February 2024, using the keywords "Vestibular migraine," "VM-PATHI," and "Patient-Reported Outcome Measure." Only studies involving human participants were included, and no additional restrictions were applied. The reference lists of included studies were also reviewed to identify other eligible studies. The main outcome of interest was the evaluation of VM-PATHI in patients with VM.
The VM-PATHI is a 25-item questionnaire divided into six sections: headache equivalents, motion sensitivity, anxiety, cognition, disequilibrium/central audiovestibular disturbance, and emotion/sense of being overwhelmed. This tool has demonstrated good face and content validity, discriminant validity, responsiveness, test-retest reliability, and internal reliability (Cronbach's α: 0.92). Patients with VM are likely to show clinical improvement in symptoms if their VM-PATHI scores decrease by ≥6 points. Additionally, VM-PATHI has shown a good correlation with clinical improvement across various treatment modalities.
The VM-PATHI may provide advantages over other PROMs by measuring a wider spectrum of disease-specific effects of VM. Scores are correlated with the DHI, dizzy days per month, and other quality of life metrics.
前庭性偏头痛（VM）具有广泛的临床表现，会对生活质量产生重大负面影响。目前，尚无客观测试可用于确诊或评估VM的严重程度。评估疾病严重程度的唯一可用工具是患者报告结局测量指标（PROMs），如头晕残障量表（DHI）。
本手稿旨在总结关于一种新开发的PROM的现有知识，该PROM称为前庭性偏头痛患者评估工具和残障量表（VM-PATHI）。
截至2024年2月，在科学网、Scopus、PubMed和谷歌学术数据库中进行了全面检索，使用关键词“前庭性偏头痛”、“VM-PATHI”和“患者报告结局测量指标”。仅纳入涉及人类参与者的研究，未施加其他限制。还对纳入研究的参考文献列表进行了审查，以识别其他符合条件的研究。主要关注的结局是对VM患者的VM-PATHI进行评估。
VM-PATHI是一份包含25个条目的问卷，分为六个部分：头痛等效症状、运动敏感性、焦虑、认知、不平衡/中枢听觉前庭障碍以及情绪/不知所措感。该工具已证明具有良好的表面效度和内容效度、区分效度、反应性、重测信度和内部信度（Cronbach's α：0.92）。如果VM患者的VM-PATHI评分降低≥6分，其症状可能会出现临床改善。此外，VM-PATHI在各种治疗方式下均与临床改善表现出良好的相关性。
VM-PATHI通过测量VM更广泛的疾病特异性影响可能比其他PROMs具有优势。其评分与DHI、每月头晕天数及其他生活质量指标相关。
