Vestibular migraine patients are more anxious than migraine patients without vestibular symptoms.

The link between vertigo and anxiety is well known. The aim of this study is to compare anxiety disorders in 3 groups: patients with vestibular migraine (VM), patients with migraine but without vertigo (MO) and healthy controls (HC).We performed cross-sectional analysis of following tests: (a) Hamilton Anxiety Rating Scale (HAMA); (b) State-Trait Anxiety Inventory (STAI-X1 and STAI-X2); (c) Beck Depression Inventory (BDI); (d) Panic-Agoraphobic Scale and (e) Penn State Worry Questionnaire (PSWQ). ANOVA, Kruskal-Wallis and Chi-square tests were used for comparisons and least significant difference was used for further post-hoc analysis. There were 35 definite VM patients, 31 MO patients and 32 volunteer HC. There were no significant differences between three groups in age, total years of education or duration of headaches in VM and MO patients. On the other hand, vertigo severity  was moderately and positively correlated with headache severity and with headache duration. There were significant differences in scores of HARS, BDI, PSWQ, and various PAS-R sub-scales between the three groups. Our study shows that VM patients are significantly more anxious and agoraphobic than MO patients and HC, displaying higher sensitivity to separation and being more prone to seeking medical reassurance.

Vestibular rehabilitation in acute central vestibulopathy: a randomized controlled trial.

OBJECTIVE: To investigate the effects of two different rehabilitation programs in acute central vestibulopathy secondary to posterior circulation stroke. METHOD: A prospective randomized controlled study was conducted on 25 patients with posterior circulation stroke. Patients were instructed in routine balance and mobility exercises during the acute hospitalization period. At discharge, patients were assigned to either a rehabilitation or home exercise group. The home exercise group was instructed to perform the same exercise program provided in the course of hospitalization period. The rehabilitation group was randomized into the visual feedback posturography training or vestibular rehabilitation group. The balance and gait performance were assessed with clinical and objective measurements before and after 6 weeks of training. RESULTS: The balance and gait scores were significantly improved in both rehabilitation groups and in the home exercise group (p< 0.05), but no significant difference was found between the groups in terms of post-treatment values (p> 0.05). CONCLUSION: The improvements of balance and gait function in rehabilitation groups did not differ from the home exercise group. Rehabilitation programs were equally effective to improve the recovery in acute central vestibulopathy.

A longitudinal study of balance in migraineurs.

CONCLUSION: Balance in migraineurs, even in those without vestibular symptoms, deteriorates slightly over 1 year in the most challenging test conditions, when measured with posturography. OBJECTIVE: To discover by a longitudinal study of a group of migraineurs and their controls, whether the well-known, mild imbalance found on posturography in migraineurs is static or progressive. METHODS: Posturographic measures of sway under incrementally more challenging conditions (up to eyes closed standing on a foam surface with the head extended) using the modified clinical test of sensory interaction on balance, limits of stability test, and tandem gait tests in a group of 19 migraineurs and 19 age- and gender-matched controls, all of whom who had been tested over 1 year before. RESULTS: After 1 year migraineurs showed a slight but statistically significant deterioration: in postural sway especially, when measured with eyes closed standing on a foam surface with the head extended backwards; in reaction time; and in maximal excursion on the limits of the stability test; and perhaps in walk speed and step width on the tandem walk test.