Clinical Features of Migraine, Vestibular Migraine, and Tension-Type Headache and Their Vestibular Evoked Myogenic Potential Study
Bibliographic record
Abstract
Background: Migraine, vestibular migraine (VM), and tension-type headache (TTH) are commonly associated with dizziness, vertigo, and postural instability, which increases patients' risk of falling and contributes to anxiety and depression. However, the vestibular pathophysiology underlying these primary headache disorders remains unclear. This study aimed to assess the saccular and utricular functions using vestibular evoked myogenic potentials (VEMPs), to investigate the peripheral and central vestibular involvement across these headaches. Methods: A total of 353 patients diagnosed with migraine, VM, or TTH, based on the International Classification of Headache Disorders, third edition (beta version, ICHD-3β), were recruited from the Dizziness and Headache Clinic at People's Hospital of Weifang between December 2019 and September 2022. All participants underwent standardized clinical assessments and demographic data collection. VEMP tests were performed using 95 dB air-conducted sound stimuli to evaluate peripheral and central vestibular functions prior to enrollment. Results: Sleep disturbances and psychiatric comorbidities (i.e., anxiety and depression) were significantly more prevalent in TTH patients compared to those with VM and migraine. VM patients also demonstrated higher rates of psychiatric comorbidities than migraine patients. The average headache duration in VM patients was 7.14 years, which was notably longer than the average dizziness duration of 4.03 years. Transient vertigo was reported in 22% of VM patients and 17.65% of TTH patients. The prevalence of occipital and/or neck pain was significantly higher in VM patients than in migraine patients. Absent ocular VEMP (oVEMP) responses, both unilateral and bilateral, were found at a significantly higher rate in VM patients compared to migraine patients. Additionally, cervical VEMP (cVEMP) asymmetry ratios (ARs) were significantly higher in VM patients compared to TTH patients, and marginally higher than in migraine patients (P = 0.05). Prolonged cVEMP latencies (right p13, n23, and interpeak intervals) were observed in both VM and migraine compared to TTH. Left-sided latencies were significantly prolonged in migraine than TTH. Conclusions: Psychiatric comorbidities were most pronounced in TTH, followed by VM and migraine. Both VM and TTH were associated with transient vertigo, exposing patients to drop-attack risk. The significantly higher occipital and/or neck pain reported in VM than in migraine may suggest the cervical neurovascular involvement in its pathophysiology. VEMP results indicate peripheral vestibular dysfunctions in VM patients and lower brainstem involvement in both VM and migraine patients, with the right-sided abnormalities more severe than the left-sided ones.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".