A preliminary clinical study related to vestibular migraine and cognitive dysfunction.

Background and purpose: Vestibular migraine (VM) is a common clinical disorder with a genetic predisposition characterized by recurrent episodes of dizziness/vertigo. Patients often complain of the presence of cognitive dysfunction manifestations such as memory loss, which causes great distress in daily life. In this study, we will explore the characteristics and possible risk factors of VM-related cognitive dysfunction by observing the cognitive function and vestibular function status of VM patients, laying the foundation for further exploration of the mechanisms of VM-related cognitive dysfunction. Methods: This study included 61 patients with VM and 30 healthy individuals matched for age, gender, and education level. All subjects underwent the Addenbrooke's Cognitive Examination-Revised (ACE-R), Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) at the first time of enrollment. Based on the ACE-R scores, the VM group was divided into the VM with cognitive dysfunction (VM-CogD) group (ACE-R < 86) and the VM without cognitive dysfunction (VM-NoCogD) group (ACE-R ≥ 86). The VM-CogD group was further categorized based on DHI scores into mild, moderate, and severe dizziness/vertigo subgroups (DHI ≤ 30 for mild, 30 < DHI ≤ 60 as moderate, and DHI > 60 as severe). All subjects underwent the head-shaking test, head-impulse test, test of skew, Romberg test, Unterberger test, videonystagmography, and caloric test to evaluate their vestibular function including the semicircular canals, vestibulo-ocular reflex pathway, and vestibulo-spinal reflex pathway. Differential analysis, correlation analysis, and ROC curve analysis were used to analyze the characteristics and influencing factors of the above clinical indicators in VM patients. It was considered that Results: There were no significant differences between the VM group and healthy control (HC) group in sex, age and education level. The total ACE-R score of the VM group was [82 (68.5, 87)], and the total ACE-R score, memory, verbal fluency, language, and visuospatial function scores were significantly lower than those of the HC group ( Conclusion: (1) VM Patients exhibit multifaceted vestibular dysfunction and varying degrees of cognitive dysfunction, and cognitive function is affected by age, duration of illness, years of education, and vestibular function; (2) VM is a functional disorder, and the function disturbance, in conjunction with anxiety and depression, may participate in the occurrence of development of cognitive dysfunction in VM.