BACKGROUND Vestibular migraine (VM) is a relatively recently acknowledged vestibular syndrome with a very relevant prevalence of about 10% among patients complaining of vertigo. The diagnostic criteria for VM have been recently published by the Bárány Society, and they are now included in the latest version of the International Classification of Headache Disorders, yet there is no instrumental test that supports the diagnosis of VM. OBJECTIVE In the hypothesis that the integration of different vestibular stimuli is functionally impaired in VM, we tested whether the combination of abrupt vestibular stimuli and full-field, moving visual stimuli would challenge vestibular migraine patients more than controls and other non-vestibular migraineurs. METHODS In three clinical centers, we compared the performance in the functional head impulse test (fHIT) without and with an optokinetic stimulus rotating in the frontal plane in a group of 44 controls (Ctrl), a group of 42 patients with migraine (not vestibular migraine, MnoV), a group of 39 patients with vestibular migraine (VM) and a group of 15 patients with vestibular neuritis (VN). RESULTS The optokinetic stimulation reduced the percentage of correct answers (%CA) in all groups, and in about 33% of the patients with migraine, in as many as 87% of VM patients and 60% of VN patients, this reduction was larger than expected from controls' data. CONCLUSIONS The comparison of the fHIT results without and with optokinetic stimulation unveils a functional vestibular impairment in VM that is not as large as the one detectable in VN, and that, in contrast with all the other patient groups, mainly impairs the capability to integrate different vestibular stimuli.

中文翻译：

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多感觉运动刺激的整合在前庭偏头痛患者中受损。

背景技术前庭偏头痛（VM）是一种相对较新近公认的前庭综合征，在抱怨眩晕的患者中患病率非常相关，约为10％。BVM的诊断标准最近由Bárány协会发布，现在已包含在最新版本的《国际头痛分类》中，但尚无支持VM诊断的仪器测试。目的在VM中不同前庭刺激的功能受损的假设下，我们测试了突然前庭刺激与全视野，移动视觉刺激的组合是否比对照和其他非前庭偏头痛患者对前庭偏头痛的挑战更大。方法在三个临床中心，我们比较了44例对照组（Ctrl），42例偏头痛（非前庭偏头痛，MnoV）患者的功能性头部冲动测试（fHIT）在前视平面旋转和不进行视动刺激时的表现。组39例前庭偏头痛（VM）和15例前庭神经炎（VN）。结果光动能刺激降低了所有组中的正确答案（％CA）的百分比，在约33％的偏头痛患者中，多达87％的VM患者和60％的VN患者中，这种降低大于预期从控件的数据。结论比较有和没有光动力刺激的fHIT结果揭示了VM的功能性前庭损伤不如VN中可检测到的那样。