Abstract
Background: It is evidenced that migraineurs present balance deficits. However, the balance recovery following unexpected ground perturbations, which reflect conditions of everyday activities, has not been investigated in this population.Aim: We aimed to assess the reactive postural responses among patients with migraine with and without aura, chronic migraine, and controls. We further aimed to assess the factors associated with greater self-report of falls.Methods: Ninety patients diagnosed by headache specialists were equally classified into three migraine subgroups according to the presence of aura and chronic migraine. Thirty controls were also recruited. All participants underwent the motor control test (MCT) and adaptation test (ADT) protocols of dynamic posturography tests (EquiTest®, NeuroCom, USA). Clinical and headache features and information on falls in the previous year, fear of falling, and vestibular symptoms were also assessed.Results: Patients with aura presented a greater sway area in most of the MCT conditions than the other three groups (p = 0.001). The aura group also presented delayed latency responses after perturbations compared with controls and patients without aura (p < 0.03). In the ADT, a greater sway area was observed in patients with aura than in groups without aura, chronic migraine, and controls (p < 0.0001). The MCT and ADT sway area, the frequency of aura, and the fear of falling explained 46% of the falls in the previous 12 months.Conclusion: Patients with aura exhibited greater delay and sway area after unexpected ground perturbations than controls and other migraine subgroups, which are related to the reported number of falls.
Highlights
We included women from 18 to 55 years old
The sample of migraineurs was recruited in a tertiary headache center and the local community, with migraine diagnosis made by neurologists, following the criteria established by the International Headache Society in the third edition of the International Classification of Headache Disorders [15]
Patients with migraine (n = 90) were stratified into three subgroups according to the presence of aura and frequency of attacks over 15 days within a month
Summary
We included women from 18 to 55 years old. Migraine participants had to have a minimum of 3 days of headache per month within the last 3 months. Controls were included if they reported no primary headache, and any secondary headache with occurrence greater than two times within the last. Abnormal neurological examination results and patients with any concomitant primary or secondary headaches (i.e., tension-type headache or medication-overuse headache) were excluded. For the homogeneity of the sample, patients with aura had to be diagnosed with typical aura, and we did not include the diagnosis of brainstem aura, hemiplegic migraine, or retinal migraine. If patients reported a migraine attack on the appointment day, the evaluation was rescheduled to a headache-free day. It is evidenced that migraineurs present balance deficits. The balance recovery following unexpected ground perturbations, which reflect conditions of everyday activities, has not been investigated in this population
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