A case-control study of visually evoked postural responses in childhood with primary headaches

Neurol Sci. 2020 Feb;41(2):305-311. doi: 10.1007/s10072-019-04072-2. Epub 2019 Sep 9.

Abstract

Background: Disorientation, nausea, confusion, dizziness, and displacement are frequently complained by headache-suffering children. Anyhow, the cause of these symptoms is still unclear, and a dysfunction of vestibular pathways or their alteration due to central pain pathways hyper-activation, has been proposed. The aim of this study is to use posturography to explore the balance function of headache-suffering children during pain-free periods.

Methods: Posturography was performed on 19 migraineurs, 11 tension-type headache sufferers, and 20 healthy controls. Posturographic measures were performed during headache-free periods under different conditions: with eyes opened, eyes closed, and during right and left optokinetic stimulation. The last 2 conditions were used to mimic unreliable visual signals that can confound vestibular system.

Results: During eyes-closed conditions, headache-suffering children displayed higher displacements than healthy controls, since statokinesiogram surface was higher in tension-type headache sufferers and migraineurs compared with controls (P value = 0.0095). Romberg's index, indicating the overall stability of the subject, was lower in healthy controls than in headache sufferers (P = 0.0139), thus suggesting a vestibular impairment in the seconds. Moreover, both during right and left optokinetic stimulation, the statokinesiogram length was higher in headache-suffering children (P < 0.0001). Thereafter, statokinesiogram surface was higher in migraineurs during right optokinetic stimulation (P = 0.0388) than in tension-type headache sufferers when stimulation was directed on the opposite side (P = 0.0249).

Conclusions: These results suggest a central alteration of vestibular pathways in headache-suffering children, that makes balance function more dependent from visual inputs than healthy subjects, even in inter-ictal phases.

Keywords: Children; Migraine; Optokinetic stimulation; Statokinesiogram; Visually evoked postural response.

MeSH terms

  • Adult
  • Brain / physiopathology*
  • Case-Control Studies
  • Child
  • Dizziness / physiopathology
  • Female
  • Headache / physiopathology*
  • Humans
  • Male
  • Migraine Disorders / physiopathology*
  • Postural Balance / physiology
  • Tension-Type Headache / physiopathology*