Vestibular Migraine Investigated with Psychophysical and Oculomotor Tests

描述(申请人提供)：前庭偏头痛(VM)，定义为前庭症状，如眩晕产生的偏头痛机制，而不是其他内耳或大脑异常，是一个常见的和残疾的问题。尽管它的频率，VM的病理生理学仍然是不确定的，并且没有具体的动眼运动，姿势或知觉缺陷在这种疾病中被描述。这项建议使用定量的心理、物理和动眼运动测试来研究VM的病理生理学，其基本假设是由半规管提供的旋转信息和重力惯性信息 耳石提供的器官在VM中由大脑异常合成。将进行三个相互关联的实验来研究这一假说。在VM受试者和对照组(正常受试者、无眩晕的偏头痛患者、无偏头痛的眩晕患者)中，我们将测量前庭刺激对知觉阈值(SA1)、感知倾斜和平移幅度(SA2)和眼动反应(SA3)的影响。知觉和眼动反应被预测为大脑中增强了耳道-耳石相互作用的证据，因此当这两个线索一致时(如滚动倾斜)，它们被增强，当线索冲突时(如离心法)，它们被抑制，当耳道和耳石被单独激活时，它们是正常的。这些预测得到了为支持这一提议而收集的大量初步数据的支持。这项研究将有助于阐明 偏头痛引起前庭症状的机制可能对开发有助于识别VM的诊断测试至关重要，也可能提供科学依据 治疗这种疾病的病人。

DESCRIPTION (provided by applicant): Vestibular migraine (VM), defined as vestibular symptoms such as vertigo generated by migraine mechanisms rather than other inner ear or brain abnormalities, is a common and disabling problem. Despite its frequency, the pathophysiology of VM remains uncertain and no specific oculomotor, postural, or perceptual defect has been described in this disorder. This proposal investigates the pathophysiology of VM using quantitative psychophysical and oculomotor tests with the underlying hypothesis that the rotational information provided by the semicircular canals and the gravito-inertial information provided by the otolith organs are synthesized abnormally by the brain in VM. Three inter-related experiments will be performed to investigate this hypothesis. In VM subjects and controls groups (normal subjects, migraine patients without dizziness, dizziness patients without migraine), we will measure the effects of vestibular stimulation on perceptual thresholds (SA1), perceived magnitude of tilt and translation (SA2), and eye movement responses (SA3). Perceptual and eye movement responses are predicted to show evidence of enhanced canal-otolith interactions in the brain such that they are augmented when these two cues are congruent (e.g. roll tilt), are inhibited when the cues conflict (e.g. centrifugation), and are noral when the canals and otoliths are activated in isolation. These predictions are supported by the extensive preliminary data collected to support this proposal. This research will help to elucidate the mechanisms responsible for vestibular symptoms caused by migraine, could be critical for developing diagnostic tests that help to identify VM, and could also provide a scientific rationale for treating patients with this disorder.