A Novel Diagnostic Prediction Model for Vestibular Migraine

Neuropsychiatr Dis Treat. 2020 Jul 29:16:1845-1852. doi: 10.2147/NDT.S255717. eCollection 2020.

Abstract

Background: Increasing morbidity and misdiagnosis of vestibular migraine (VM) gravely affect the treatment of the disease as well as the patients' quality of life. A powerful diagnostic prediction model is of great importance for management of the disease in the clinical setting.

Materials and methods: Patients with a main complaint of dizziness were invited to join this prospective study. The diagnosis of VM was made according to the International Classification of Headache Disorders. Study variables were collected from a rigorous questionnaire survey, clinical evaluation, and laboratory tests for the development of a novel predictive diagnosis model for VM.

Results: A total of 235 patients were included in this study: 73 were diagnosed with VM and 162 were diagnosed with non-VM vertigo. Compared with non-VM vertigo patients, serum magnesium levels in VM patients were lower. Following the logistic regression analysis of risk factors, a predictive model was developed based on 6 variables: age, sex, autonomic symptoms, hypertension, cognitive impairment, and serum Mg2+ concentration. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.856, which was better than some of the reported predictive models.

Conclusion: With high sensitivity and specificity, the proposed logistic model has a very good predictive capability for the diagnosis of VM. It can be used as a screening tool as well as a complementary diagnostic tool for primary care providers and other clinicians who are non-experts of VM.

Keywords: cognitive function; dizziness; headache; magnesium ion; motion sickness; predictive model.

Grants and funding

This study was supported by the Key Program of the Natural Science Fund in Heilongjiang Province (No. ZD2019H006), National key research and development plan project (2016YFC1307200) and National Key Research & Development Program of China (No.2016YFC1307200).