Sensitized rotatory motion perception and increased susceptibility to motion sickness in vestibular migraine‐ a cross‐sectional study

Abstract Background: The demographic and clinical characteristics of vestibular migraine (VM) based on the International Classification of Headache Disorders (ICHD)-III beta are not well documented, and the underlying pathophysiology remains largely unknown. Based on evidence that central sensitization is involved in VM pathogenesis, we hypothesized that cutaneous allodynia (CA), which is a clinical manifestation of central sensitization, and interictal widespread pressure hyperalgesia (IWPH), which may be an accelerator for central sensitization, are more frequently associated with VM patients compared with non-VM patients. The aim of this study was as follows: 1) to assess differences in demographic and clinical characteristics among VM patients, patients with migraine with vestibular symptoms not meeting VM criteria (MwVS), and patients with migraine without vestibular symptoms (MwoVS); and 2) to evaluate whether VM patients were more frequently associated with CA/IWPH compared with the other two groups.Methods: This cross-sectional study enrolled consecutive migraine patients, aged 18–65. The comprehensive interview form included diagnostic questions of migraine and VM, demographic characteristics, migraine-specific variables, migraine-associated symptoms, and CA. IWPH occurrence was investigated using a manual tender point survey and clinical parameters were compared.Results: A total of 245 episodic migraineurs (mean age = 39.5 ± 11.3 years, 81.2% women) were enrolled. Based on ICHD-III beta criteria, 65 (26.5%), 74 (30.2%), and 106 (43.3%) patients were assigned to the VM group, MwVS group, or MwoVS group, respectively. Pairwise comparisons demonstrated no significant differences between the VM and MwVS groups, except for higher occurrence of headache disability in the VM group. Compared with the MwoVS group, the VM group was significantly associated with aura, severe disability, depression, tinnitus, sleep disorders, multimodal CA, and IWPH.Conclusions: There were no significant differences in clinical features between VM and MwVS groups, except for disability, which was possibly caused by criteria selection bias. VM and MwVS may be on the same disease process spectrum. Widespread multimodal CA, including clinical manifestations of thalamic sensitization, was significantly associated with VM patients compared with MwoVS patients, which indicates that thalamic sensitization may play a key role VM pathogenesis. Furthermore, IWPH may enhance susceptibility to thalamic sensitization.

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Biomarkers of susceptibility and effect in car painters exposed to organic solvents

Colombia Medica ◽

10.25100/cm.v51i1.3646 ◽

2020 ◽

Author(s):

Marcela Varona-Uribe ◽

Milciades Ibáñez-Pinilla ◽

Leonardo Briceno-Ayala ◽

Diego Herrera ◽

Lilian Chuaire-Noack ◽

...

Keyword(s):

Occupational Exposure ◽

Somatic Cell ◽

Organic Solvents ◽

Cross Sectional Study ◽

Exposed Group ◽

Exposure Group ◽

Sectional Study ◽

Genotoxic Effects ◽

Cross Sectional ◽

Increased Susceptibility

Introduction: Car painters are routinely exposed to organic solvents classified as carcinogenic and mutagenic substances. Objective: To characterize the population susceptibility and evaluate the genotoxic effects of exposure to organic solvents. Methods: A cross-sectional study comparing a group of car painters exposed to organic solvents with a non-exposed group. CYP2E1 polymorphisms and the presence of micronuclei in lymphocytes were determined. Results: One hundred twenty-two workers participated in the study: 62 who worked in car paint shops and were exposed to solvents, and 60 who were not exposed. There were statistically significant differences between the two groups regarding micronucleated cells and nucleoplasmic bridges frequencies (p=0.042 and p=0.046, respectively; exact likelihood ratio). Significant differences were found at the interaction between the CYP2E1 genotype c1c1 and occupational exposure to solvents, with higher frequencies of micronuclei (p= 0.013) and micronucleated cells (p= 0.015). However, when the frequencies of micronuclei, micronucleated cells and nucleoplasmic bridges in the exposure group were compared between the c1c1 and c2c2/c1c2 allele groups of the CYP2E1 polymorphism, statistically significant differences were found. Conclusions: This study confirms that when workers with CYP2E1 polymorphisms, specifically the c1c1 genotype, are exposed to organic solvents, they are more likely to have somatic cell mutations, a condition associated with increased susceptibility to diseases such as cancer

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Reduced vestibular perception thresholds in persistent postural-perceptual dizziness- a cross-sectional study

BMC Neurology ◽

10.1186/s12883-021-02417-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sebastian Wurthmann ◽

Dagny Holle ◽

Mark Obermann ◽

Miriam Roesner ◽

Michael Nsaka ◽

...

Keyword(s):

Motion Perception ◽

Cross Sectional Study ◽

Pathophysiological Mechanism ◽

Sectional Study ◽

Cross Sectional ◽

Motion Sensitivity ◽

Ocular Reflex ◽

Vestibular Ocular Reflex ◽

Significant Difference ◽

Vestibular Perception

Abstract Background Persistent postural-perceptual dizziness (PPPD) is the most common functional vestibular disorder. A multisensory mismatch altered by psychological influences is considered to be an important pathophysiological mechanism. Increased cortical and subcortical excitability may play a role in the pathophysiology of PPPD. We hypothesized that decreased motion perception thresholds reflect one mechanism of the abnormal vestibular responsiveness in this disorder. We investigated the vestibular perception thresholds and the vestibular ocular reflex with a rotatory chair experiment to gain insights in the processing and adaption to vestibular provocation. Methods In this cross-sectional study 26 female PPPD patients and 33 healthy female age matched controls (HC) were investigated sitting in a motorized rotary chair shielded regarding visual and acoustic stimuli. The chair was rotated for 20 minutes with slowly increasing velocity to a maximum of 72°/s. We functionally tested motion perception thresholds and vegetative responses to rotation as well as vestibular-ocular reflex thresholds. We additionally investigated several psychological comorbidities (i.e. depression, anxiety, somatosensory amplification) using validated scores. Conventional dizziness scores were obtained to quantify the experienced dizziness and impact on daily life. Results PPPD patients showed a significant reduced vestibulo-perceptual threshold (PPPD: 10.9°/s vs. HC: 29.5°/s; p<0.001) with increased motion sensitivity and concomitant vegetative response during and after the chair rotation compared to healthy controls. The extent of increased vestibular sensitivity was in correlation with the duration of the disease (p=0.043). No significant difference was measured regarding nystagmus parameters between both groups. Conclusion PPPD patients showed increased vegetative response as well as decreased vestibulo-perceptual thresholds which are related to disease duration. This is of interest as PPPD might be sustained by increased vestibular excitability leading to motion intolerance and induction of dizziness when exposed to movement.

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Abnormal visuo-vestibular interactions in vestibular migraine: a cross sectional study

Brain ◽

10.1093/brain/awy355 ◽

2019 ◽

Vol 142 (3) ◽

pp. 606-616 ◽

Cited By ~ 11

Author(s):

Nadja F Bednarczuk ◽

Angela Bonsu ◽

Marta Casanovas Ortega ◽

Anne-Sophie Fluri ◽

John Chan ◽

...

Keyword(s):

Cross Sectional Study ◽

Vestibular Migraine ◽

Sectional Study ◽

Cross Sectional

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Visually Evoked Postural Responses (VEPRs) in Children with Vestibular Migraine

Children ◽

10.3390/children9010014 ◽

2021 ◽

Vol 9 (1) ◽

pp. 14

Author(s):

Riccardo Nocini ◽

Carlo Baraldi ◽

Enrico Apa ◽

Andrea Ciorba ◽

Daniele Monzani ◽

...

Keyword(s):

Primary Headache ◽

Cross Sectional Study ◽

Vestibular Migraine ◽

Body Sway ◽

Sectional Study ◽

Cross Sectional ◽

Full Field ◽

Optokinetic Reflex ◽

Episodic Vertigo ◽

Postural Responses

Vestibular migraine (VM) is the most common cause of episodic vertigo in children. Vertigo, nausea, dizziness and unsteadiness are often complained of by children with migraine, which can precede, follow or be present simultaneously with headache. The aim of this study was to use posturography to investigate the visually evoked postural responses (VEPRs) of children with VM and compare them to data obtained from children with primary headache (M) and controls (C). Twenty children diagnosed as affected by VM, nineteen children with M without aura and twenty healthy subjects were recruited in this cross-sectional study. Posturography was performed by a standardized stabilometric force-platform (Svep-Politecnica) in the following conditions: open eyes (OE), closed eyes (CE) and during full-field horizontal optokinetic stimulation (OKN-S). Electronystagmography was performed simultaneously to analyze optokinetic reflex parameters. In the OE condition, no difference was found between groups with respect to body sway area. In contrast, this parameter increased in the two pathological groups with respect to controls in the CE condition. The optokinetic stimulations also induced a similar increase of body sway area in the M group relative to controls, but a further increase was elicited in the VM group. Electronystagmographic recording also revealed different optokinetic reflex parameters in the latter groups. This study disclosed an abnormal sensitivity of children with M and VM to full-field moving scenes and a consequent destabilization of posture, as documented by the abnormal VEPRs. Children with VM were particularly exposed to this risk. Possible clinical implications of these findings are discussed.

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Reduced Vestibular Perception Thresholds in Persistent Postural-Perceptual Dizziness- A Cross-Sectional Study

10.21203/rs.3.rs-142976/v1 ◽

2021 ◽

Author(s):

Sebastian Wurthmann ◽

Dagny Holle-Lee ◽

Mark Obermann ◽

Miriam Roesner ◽

Michael Nsaka ◽

...

Keyword(s):

Motion Perception ◽

Cross Sectional Study ◽

Sectional Study ◽

Vestibular Disorder ◽

Cross Sectional ◽

Motion Sensitivity ◽

Ocular Reflex ◽

Vestibular Ocular Reflex ◽

Significant Difference ◽

Vestibular Perception

Abstract BACKGROUND: Persistent postural-perceptual dizziness (PPPD) is the most common functional vestibular disorder which is maintained by an interaction of psychological and physiological factors. PPPD patients develop inappropriate postural control strategies characterized by increased self-motion perception. Increased cortical and subcortical excitability may play a role in the pathophysiology of PPPD. We hypothesized that decreased motion perception thresholds reflect one mechanism of the abnormal vestibular responsiveness in this disorder. We investigated the vestibular perception thresholds and the vestibular ocular reflex with a rotatory chair experiment to gain insights in the processing and adaption to vestibular provocation. METHODS: In this cross-sectional study 26 female PPPD patients and 33 healthy female age and matched controls (HC) were investigated sitting in a motorized rotary chair shielded regarding visual and acoustic stimuli. The chair was rotated for 20 minutes with slowly increasing velocity to a maximum of 72°/s. We functionally tested motion perception thresholds and vegetative responses to rotation as well as vestibular-ocular reflex thresholds. We additionally investigated several psychological comorbidities (i.e. depression, anxiety, somatosensory amplification) using validated scores. Conventional dizziness scores were obtained to quantify the experienced dizziness and impact on daily life. RESULTS: PPPD patients showed a significant reduced vestibulo-perceptual threshold (PPPD: 10.9°/s vs. HC: 29.5°/s; p<0.001) with increased motion sensitivity and concomitant vegetative response during and after the chair rotation compared to healthy controls. The extent of increased vestibular sensitivity was in correlation with the duration of the disease (p=0.043). No significant difference was measured regarding nystagmus parameters between both groups.CONCLUSION: PPPD patients showed increased vegetative response as well as decreased vestibulo-perceptual thresholds which are related to disease duration. This is of interest as PPPD might be sustained by increased vestibular excitability leading to motion intolerance and induction of dizziness when exposed to movement.

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Patients' understanding of words used to describe lumps: a cross-sectional study

The Journal of Laryngology & Otology ◽

10.1017/s0022215105006481 ◽

2005 ◽

pp. 1

Author(s):

Neil K Chadha ◽

Costa Repanos

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Does a Graduate Course in Fluency Disorders Make a Difference?

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd20.1.10 ◽

2010 ◽

Vol 20 (1) ◽

pp. 10-14 ◽

Cited By ~ 2

Author(s):

Evelyn R. Klein ◽

Barbara J. Amster

Keyword(s):

Undergraduate Students ◽

Graduate Programs ◽

The United States ◽

Cross Sectional Study ◽

Sectional Study ◽

Graduate Course ◽

Cross Sectional ◽

Fluency Disorders ◽

Introductory Course ◽

Communicative Disorders

Abstract A study by Yaruss and Quesal (2002), based on responses from 134 of 239 ASHA accredited graduate programs, indicated that approximately 25% of graduate programs in the United States allow students to earn their degree without having coursework in fluency disorders and 66% of programs allow students to graduate without clinical experience treating people who stutter (PWS). It is not surprising that many clinicians report discomfort in treating PWS. This cross-sectional study compares differences in beliefs about the cause of stuttering between freshman undergraduate students enrolled in an introductory course in communicative disorders and graduate students enrolled and in the final weeks of a graduate course in fluency disorders.

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