Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2016 Oct;273(10):2931-9.
doi: 10.1007/s00405-015-3835-y. Epub 2016 Jan 4.

Comparison of linear motion perception thresholds in vestibular migraine and Menière's disease

Tatiana Bremova  1   2 , Arla Caushaj  3 , Matthias Ertl  3   4 , Ralf Strobl  3   5 , Nicolina Böttcher  3   6 , Michael Strupp  3   6 , Paul R MacNeilage  3   4
Affiliations
Comparative Study

Comparison of linear motion perception thresholds in vestibular migraine and Menière's disease

Tatiana Bremova et al. Eur Arch Otorhinolaryngol. 2016 Oct.

Abstract

Linear motion perceptual thresholds (PTs) were compared between patients with Menière's disease (MD) and vestibular migraine (VM). Twenty patients with VM, 27 patients with MD and 34 healthy controls (HC) were examined. PTs for linear motion along the inter-aural (IA), naso-occipital axes (NO), and head-vertical (HV) axis were measured using a multi-axis motion platform. Ocular and cervical vestibular evoked myogenic potentials (o/c VEMP) were performed and the dizziness handicap inventory (DHI) administered. In order to discriminate between VM and MD, we also evaluated the diagnostic accuracy of applied methods. PTs depended significantly on the group tested (VM, MD and HC), as revealed by ANCOVA with group as the factor and age as the covariate. This was true for all motion axes (IA, HV and NO). Thresholds were highest for MD patients, significantly higher than for all other groups for all motion axes, except for the IA axis when compared with HC group suggesting decreased otolith sensitivity in MD patients. VM patients had thresholds that were not different from those of HC, but were significantly lower than those of the MD group for all motion axes. The cVEMP p13 latencies differed significantly across groups being lowest in VM. There was a statistically significant association between HV and NO thresholds and cVEMP PP amplitudes. Diagnostic accuracy was highest for the IA axis, followed by cVEMP PP amplitudes, NO and HV axes. To conclude, patients with MD had significantly higher linear motion perception thresholds compared to patients with VM and controls. Except for reduced cVEMP latency, there were no differences in c/oVEMP between MD, VM and controls.

Keywords: Diagnostic accuracy; Menière’s disease; Otolith function; Perception thresholds; Saccule; Utricle; Vestibular migraine.

PubMed Disclaimer

Conflict of interest statement

T. Bremova and N. Böttcher received honoraria for lecturing from Actelion. A. Caushaj, M. Ertl, P. MacNeilage, R. Strobl report no disclosures. M. Strupp is Joint Chief Editor of the Journal of Neurology, Editor in Chief of Frontiers of Neuro-otology and Section Editor of F1000. He has received speaker’s honoraria from Abbott, Actelion, Biogen, Eisai, GSK, Henning Pharma, Interacoustics, MSD, Otometrics, Pierre-Fabre, TEVA, UCB. He acts as a consultant for Abbott and Actelion. Study funding Supported by German Ministry of Education and Research grant code 01 EO 0901 to the German Center for Vertigo and Balance Disorders at the University of Munich, Campus Großhadern.

Figures

Fig. 1
Fig. 1
Example of individual staircase history (a) and psychometric fit (b). The 2D1U staircase terminated after 50 trials. Filled and unfilled points show correct and incorrect responses, respectively. b Cumulative Gaussian fit to data from (a). Proportion of correct responses is plotted as a function of the log of the stimulus magnitude. Threshold is the stimulus value corresponding to 84 % correct shown by red dashed lines in a and b
Fig. 2
Fig. 2
Vestibular perceptual thresholds (PTs). a Inter-aural (IA) axis, b Head-vertical (HV) axis, c Naso-occipital (NO) axis. Lines show linear fits by study group. Vestibular migraine (VM) indicated by yellow diamonds and dashed line. Menière’s disease (MD) indicated by blue circles and solid line. Healthy controls (HC) indicated by green triangles and dotted line. d Thresholds replotted for all study groups to compare axes: IA, HV, and NO, indicated by dark blue, red, and light blue circles and lines, respectively
Fig. 3
Fig. 3
Absolute difference (delta) in perceptual thresholds between groups; Menière’s disease (MD), vestibular migraine (VM), heathy controls (HC). *Statistically significant values on the level of p < 0.05. **Statistically significant values on the level of p < 0.001
See this image and copyright information in PMC

References

    1. Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol. 1999;246:883–892. doi: 10.1007/s004150050478. - DOI - PubMed
    1. Lempert T, Olesen J, Furman J, et al. Vestibular migraine: diagnostic criteria. J Vestib Res Equilib Orientat. 2012;22:167–172. - PubMed
    1. Lopez-Escamez JA, Carey J, Chung W-H, et al. Diagnostic criteria for Menière’s disease. J Vestib Res Equilib Orientat. 2015;25:1–7. - PubMed
    1. Strupp M, Thurtell MJ, Shaikh AG, et al. Pharmacotherapy of vestibular and ocular motor disorders, including nystagmus. J Neurol. 2011;258:1207–1222. doi: 10.1007/s00415-011-5999-8. - DOI - PMC - PubMed
    1. Gürkov R, Flatz W, Louza J, et al. In vivo visualized endolymphatic hydrops and inner ear functions in patients with electrocochleographically confirmed Menière’s disease. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol. 2012;33:1040–1045. - PubMed

Publication types

MeSH terms