The journal of international advanced otology · 2026
Mapping the Sacculo-collic and Otolith-ocular Pathway Dysfunction in Individuals with Vestibular Migraine.
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Thomas Prajeesh, Sinha Sujeet Kumar
Аннотация
BACKGROUND: Vestibular migraine is the second most common cause of dizziness and is characterized by variability in migraine symptom presentation, duration, and temporal relationship to vestibular symptoms. Studies have reported alterations in amplitude and latency of vestibular-evoked myogenic potentials among individuals with vestibular migraine. But these reports have limitations in terms of sample size, number of tests, and confirmation of the diagnosis.
METHODS: A prospective standard group comparison design was employed for this study. Seventy-six individuals with confirmed vestibular migraine and 76 healthy age-matched subjects participated in this study. All of them underwent cervical vestibular-evoked myogenic potential (cVEMP) and ocular vestibular-evoked myogenic potential (oVEMP) test with a 500 Hz tone burst stimulus. The response rate, latency, and amplitude parameters were analyzed.
RESULTS: A significantly lower response rate of VEMPs was noted in vestibular migraine participants compared to the healthy group which had a 100% response rate. Among the vestibular migraine individuals, the oVEMP response rate was lower than the cVEMP response rate. There was no main effect of ear on VEMPs' latency and amplitude; hence, right and left ear responses were combined for analysis. The latency of cVEMP and oVEMP was prolonged, and the amplitude of cVEMP was reduced in vestibular migraine compared to healthy individuals.
CONCLUSION: The otolithic dysfunction in vestibular migraine could arise from vasospasm of the labyrinthine artery, disproportionately affecting the saccule and utricle. The otolith-ocular pathway dysfunction is more predominant in vestibular migraine than sacculo-collic pathway dysfunction. Reduced cVEMP amplitude and prolonged cVEMP and oVEMP latencies suggest involvement of both peripheral and central components in vestibular migraine. The heterogeneous nature of the condition explains the variety of response patterns.
METHODS: A prospective standard group comparison design was employed for this study. Seventy-six individuals with confirmed vestibular migraine and 76 healthy age-matched subjects participated in this study. All of them underwent cervical vestibular-evoked myogenic potential (cVEMP) and ocular vestibular-evoked myogenic potential (oVEMP) test with a 500 Hz tone burst stimulus. The response rate, latency, and amplitude parameters were analyzed.
RESULTS: A significantly lower response rate of VEMPs was noted in vestibular migraine participants compared to the healthy group which had a 100% response rate. Among the vestibular migraine individuals, the oVEMP response rate was lower than the cVEMP response rate. There was no main effect of ear on VEMPs' latency and amplitude; hence, right and left ear responses were combined for analysis. The latency of cVEMP and oVEMP was prolonged, and the amplitude of cVEMP was reduced in vestibular migraine compared to healthy individuals.
CONCLUSION: The otolithic dysfunction in vestibular migraine could arise from vasospasm of the labyrinthine artery, disproportionately affecting the saccule and utricle. The otolith-ocular pathway dysfunction is more predominant in vestibular migraine than sacculo-collic pathway dysfunction. Reduced cVEMP amplitude and prolonged cVEMP and oVEMP latencies suggest involvement of both peripheral and central components in vestibular migraine. The heterogeneous nature of the condition explains the variety of response patterns.