Ilmari Pyykkö1, Vinaya Manchaiah2, Markus Färkkilä3, Erna Kentala4, Jing Zou5. 1. Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland. Electronic address: http://ilmari.pyykkotuni.fi. 2. Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, United States; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India; Audiology India, Mysore, Karnataka, India. 3. Helsinki Headache Centre, Helsinki, Finland. 4. Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 5. Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland; Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
Abstract
OBJECTIVE: The aim of the present study was to evaluate complaints in people with Ménière's disease (MD) with and without migraine and headache to study the association between MD and Vestibular Migraine (VM). We believe this will help us understand if these two disorders represent a disease continuum in that they may share a common aetiology. METHODS: The study used a retrospective design and included data of 911 patients with MD from the Finnish Ménière Federation database. The study participants had a mean age of 60.2 years, mean duration of disease of 12.6 years, and 78.7% of the participants were females. The questionnaire data comprised of both disease specific and impact related questions. The data were analyzed using the Mann-Whitney U test, the Kruskal Wallis H test, logistic regression analyses, and decision tree analysis. RESULTS: Migraine and headache was reported by 190 subjects (20.9%) and 391 subjects (42.9%) respectively. We found that patients that could be classified as VM in the study (i.e., those with frequent vertigo spells associated with migraine) more often reported complaints of severe MD symptoms, had reduced health-related quality of life, suffered more from anxiety, had more neurological complaints, and experienced a reduced sense of coherence than the non-migraneous patients with MD. However, neither the decision tree analysis nor the logistic regression analysis could reliably discriminate VM from MD patients. CONCLUSION: Our study results confirm that MD is frequently associated with headache and migraine. In addition, results also indicate that migraine provokes the severity of MD. We suggest that MD and VM may share similar pathophysiological mechanisms. Hence, the future MD classification systems should include a category referred to as 'MD with migraine' that will include patients with VM.
OBJECTIVE: The aim of the present study was to evaluate complaints in people with Ménière's disease (MD) with and without migraine and headache to study the association between MD and Vestibular Migraine (VM). We believe this will help us understand if these two disorders represent a disease continuum in that they may share a common aetiology. METHODS: The study used a retrospective design and included data of 911 patients with MD from the Finnish Ménière Federation database. The study participants had a mean age of 60.2 years, mean duration of disease of 12.6 years, and 78.7% of the participants were females. The questionnaire data comprised of both disease specific and impact related questions. The data were analyzed using the Mann-Whitney U test, the Kruskal Wallis H test, logistic regression analyses, and decision tree analysis. RESULTS:Migraine and headache was reported by 190 subjects (20.9%) and 391 subjects (42.9%) respectively. We found that patients that could be classified as VM in the study (i.e., those with frequent vertigo spells associated with migraine) more often reported complaints of severe MD symptoms, had reduced health-related quality of life, suffered more from anxiety, had more neurological complaints, and experienced a reduced sense of coherence than the non-migraneous patients with MD. However, neither the decision tree analysis nor the logistic regression analysis could reliably discriminate VM from MD patients. CONCLUSION: Our study results confirm that MD is frequently associated with headache and migraine. In addition, results also indicate that migraine provokes the severity of MD. We suggest that MD and VM may share similar pathophysiological mechanisms. Hence, the future MD classification systems should include a category referred to as 'MD with migraine' that will include patients with VM.
Authors: J M van Steekelenburg; A van Weijnen; L M H de Pont; O D Vijlbrief; C C Bommeljé; J P Koopman; B M Verbist; H M Blom; S Hammer Journal: AJNR Am J Neuroradiol Date: 2020-02-06 Impact factor: 3.825