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.
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Kayan A, Hood JD (1984) Neuro-otological manifestations of migraine. Brain 107:1123–1142
Dieterich M, Brandt T (1999) Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol 246:883–892
Smitherman TA, Kolivas ED, Bailey JR (2013) Panic disorder and migraine: comorbidity, mechanisms, and clinical implications. Headache 53:23–45
Moon JS, Smith JH, Lahr BD et al (2013) Longitudinal associations of migraine and depressive symptoms: a cohort analysis. Psychosomatics 54:317–327
Neuhauser H, Lempert T (2004) Vertigo and dizziness related to migraine: diagnostic challenge. Cephalalgia 24:83–91
Eckhardt-Henn A, Dieterich M (2005) Psychiatric disorders in otoneurology patients. Neurol Clin 23:731–749
Yuan Q, Yu L, Shi D et al (2015) Anxiety and depression among patients with different types of vestibular peripheral vertigo. Medicine (Baltimore) 94(5):e453
Teggi R, Caldirola D, Colombo B et al (2010) Dizziness, migrainous vertigo and psychiatric disorders. J Laryngol Otol 124:285–290
Eckhardt-Henn A, Best C, Bense S et al (2008) Psychiatric comorbidity in different organic vertigo syndromes. J Neurol 255:420–428
Best C, Eckhardt-Henn A, Tschan R et al (2009) Psychiatric morbidity and comorbidity in different vestibular vertigo syndromes. Results of a prospective longitudinal study over one year. J Neurol 256:58–65
Lahmann C, Henningsen P, Brandt T et al (2015) Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness. J Neurol Neurosurg Psychiatry 86:302–308
Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders, 2nd edn, vol 24. Cephalalgia, pp 9–160
Godemann F, Schabowska A, Naetebusch B et al (2006) The impact of cognitions on the development of panic and somatoform disorders: a prospective study in patients with vestibular neuritis. Psychol Med 36:99–108
Staab J (2006) Chronic dizziness: the interface between psychiatry and neuro-otology. Curr Opin Neurol 19:41–48
Kirby SE, Yardley L (2012) Physical and psychological triggers for attacks in Meniere’s disease: the patient perspective. Psychother Psychosom 81:396–398
Hong MS, Lee H, Lee B et al (2013) Influence of vestibular disease on psychological distress. Multicenter study. Otolaryngol Head Neck Surg 148:810–814
Staab JP, Balaban CD, Furman JM (2013) Threat assessment and locomotion: clinical applications of an integrated model of anxiety and postural control. Semin Neurol 33(2):97–106
Furman JM, Balaban CD, Jacob RG et al (2005) Migraine-anxiety related dizziness (MARD): a new disorder? J Neurol Neurosurg Psychiatr 76:1–8
Lempert T, Neuhauser H (2009) Epidemiology of vertigo, migraine and vestibular migraine. J Neurol 256:333–338
Staab JP (2012) Chronic subjective dizziness. Continuum (Minneap Minn) 18 (5 Neuro-otology):1118–1141
Corchs F, Mercante JPP, Guendler VZ (2006) Phobias, other psychiatric comorbidities and chronic migraine. Arq Neuropsiquiatr 64:950–953
Headache Classification Committee of the International Headache Society (IHS) (2013) The International Classification of Headache Disorders, 3rd edn. (beta version), vol 33. Cephalalgia, pp 629–808
Cho SJ, Kim BK, Kim BS et al (2016) Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders, vol 36. Cephalalgia, pp 454–462
Zhang Y, Kong Q, Chen J et al (2016) International Classification of Headache Disorders 3rd edition beta-based field testing of vestibular migraine in China: demographic, clinical characteristics, audiometric findings and diagnosis. Cephalalgia 36:240–248
Ombergen AV, Rompaey VV, Heyning PV et al (2015) Vestibular Migraine in an Otolaryngology Clinic: prevalence, associated symptoms, and prophylactic medication effectiveness. Otol Neurotol 36:133–138
Akdal G, Özge A, Ergör G (2013) The prevalence of vestibular symptoms in migraine or tension-type headache. J Vestib Res 23:101–106
Akdal G, Baykan B, Ertaş M et al (2015) Population-based study of vestibular symptoms in migraineurs. Acta Otolaryngol 135:435–439
Akdal G, Özge A, Ergör G (2015) Vestibular symptoms are more frequent in migraine than in tension-type headache patients. J Neurol Sci 357:295–296
On behalf of all authors, the corresponding author states that there is no conflict of interest. Authors thank Koray Kocaoğlu for his assistance preparing the manuscript.
Conflicts of interest
Local ethics committee approved the study. All study procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Özge Kutay and Gülden Akdal authors contributed equally to this manuscript to share first authorship.
This manuscript is part of a supplement sponsored by the German Federal Ministry of Education and Research within the funding initiative for integrated research and treatment centers.
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Kutay, Ö., Akdal, G., Keskinoğlu, P. et al. Vestibular migraine patients are more anxious than migraine patients without vestibular symptoms. J Neurol 264 (Suppl 1), 37–41 (2017). https://doi.org/10.1007/s00415-017-8439-6