Visual Motion Sensitivity in Vestibular Migraine

To quantitatively assess visual motion sensitivity in vestibular migraine (VM).

Cohort study.

Single institution.

Prospective cohort of individuals with VM and healthy controls.

Subjects rated visually induced symptoms while watching 20 videos with varying degrees of optical flow. After each video, participants rated the intensity of their predominant symptom (headache, dizziness, nausea, or fogginess) on a 5-point Likert scale.

The primary outcome was a composite symptom score (sum of ratings), which was compared with other patient-reported outcome measures, including (1) Dizziness Handicap Inventory, (2) VM-Patient Assessment Tool and Handicap Inventory, and (3) Visual Vertigo Analog Scale, among other headache, cognitive, and psychometric questionnaires.

The study enrolled 17 participants with VM and 19 healthy controls. The rate of visual motion sensitivity (any symptom) was significantly higher in the VM arm [71.9% vs. 13.7% in controls, X 2 (4, 705)=245.6, P <0.001]. Composite symptom scores were significantly higher in the VM arm (43.9±13.9 vs. 23.6±6.3 in controls, U =304.0, P <0.001) and significantly correlated with symptom-related measures ( P <0.001 for each). Visual Vertigo Analog Scale correlated with composite scores within the VM arm ( P <0.001) and the control arm ( P =0.01, although not significant after Bonferroni correction).

Visual motion sensitivity is more frequent in those with VM than in healthy controls, and symptom scores correlated with other established patient-reported outcome measures, especially the Visual Vertigo Analog Scale. Visual motion sensitivity is a distinct and measurable feature of VM and can inform disease severity and treatment response.