Abstract
Objective
To study the value of the subjective visual vertical (SVV) in the diagnosis of vestibular migraine (VM).
Methods
This study recruited 128 VM patients and 64 age-matched normal subjects. We detected the SVV during the interval between attacks in both groups, in sitting upright, and the head tilted at 45° to the left or right. We then examined the correlation between the SVV results with the vestibular evoked myogenic potential (VEMP) and canal paresis (CP).
Results
It was found there was a significant difference in SVV at the upright position between VM patients and normal controls (P=0.006) and no significant difference was found at the tilts of 45° to the left or right between the two groups. The SVV results at the upright position were significantly correlated with cervical VEMP (P=0.042) whereas not significantly correlated with CP and VEMP. There existed no significant difference in the conformity to the Müller effect (M effect) between the two groups. ROC analysis exhibited that the sensitivity, specificity of SVVs at the upright were 67.200% and 62.500% respectively. The diagnostic value of SVV at the upright position was significantly higher than that at tilts of 45° to the left and right (P=0.006). Nonetheless the diagnostic accuracy was relatively low.
Conclusion
Abnormality in SVV possibly stems from the lasting functional disorder of cerebellar or high-level cortical centers in VM patients or is linked to the vestibular compensation. The SVV is of low diagnostic value for VM and the value of SVV in VM warrants further study.
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All authors declare no conflicts of interest.
Author Su-ling ZHANG is a young member of the Editorial Board for Current Medical Science. The paper was handled by the other Editor and has undergone rigrous peer review process. Author Su-ling ZHANG was not involved in the journal’s review of, or decisions related to, this manuscript.
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This study was funded by grants from the Shanghai Science and Technology Commission (No. 18ZR1439200), the National Natural Science Foundation of China (No. 81873701), the Innovation Items in the Military Service Field of Changzheng Hospital (No. 2019CZJS102, No. 2020CZWJFW10) and the National Twelfth Five-Year Research Program of China (No. 2012BAI12B02).
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Li, F., Xu, J., Li, Gr. et al. The Value of Subjective Visual Vertical in Diagnosis of Vestibular Migraine. CURR MED SCI 41, 654–660 (2021). https://doi.org/10.1007/s11596-021-2418-y
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DOI: https://doi.org/10.1007/s11596-021-2418-y