Author(s)
Evan J. Patel, MD
Maxwell Hum, BA
Adam Z. Gardi, BA
Kristen K. Steenerson, MD
Habib G. Rizk, MD
Jeffrey D. Sharon, MD
Affiliation(s)
Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, Department of Neurology & Neurological Sciences, Stanford University, Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina
Abstract:
Objective: To assess changes in cognitive function in vestibular migraine patients undergoing treatment.
Study Design: Prospective Cohort
SETTING: Single-institution tertiary-care center
PATIENTS: Thirty-four patients with vestibular migraine were included in the study. Average age at diagnosis was 47.9 years-old. The majority of patients were female (91.2%).
INTERVENTIONS: Vestibular therapies included mindfulness-based stress reduction (58.8%), pharmacologic (26.5%), and others (14.7%).
MAIN OUTCOME MEASURES: Pre- and post-treatment questionnaires were collected including the Cognitive Failures Questionnaire (CFQ), Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI) and Dizziness Handicap Inventory (DHI).
Results: Median time between pre- and post-treatment questionnaire was 4.4 months (range 2.8-15.6. months). CFQ scores decreased in subjects who responded to treatment, as defined by those with a positive change in VM-PATHI score (average decrease 6.5, p = 0.03). CFQ scores did not improve in subjects who had no improvement in their vestibular condition, as defined by no change or an increase in VM-PATHI score (average increase 2.0, p = 0.53). Univariate linear regression showed that VM-PATHI score change was highly predictive of CFQ change (p < 0.01, r-squared = 0.36). Multivariate regression demonstrated that VM-PATHI (p = 0.03) and not DHI (p = 0.10) predicted changes in CFQ score.
Conclusions: Self-reported cognitive dysfunction improves with successful treatment of vestibular migraine.
Professional Practice Gap & Education: Given the association of cognitive impairment and vestibular symptoms, cognitive
function tests are being incorporated into evaluations of patients with vestibular migraine. There is limited data to support
the correlation of self-reported surveys which assess dizziness compared to those which analyze cognitive function.
Learning Objective: To demonstrate the correlation of vestibular symptoms with cognitive function after treatment in patients
with vestibular migraine.
Desired
Results: Attendees will understand that VM-PATHI is a reliable predictor of cognitive improvement after treatment in
patients with vestibular migraine.
Level of Evidence - Level III
IRB: University of California San Francisco IRB #18-25365 (approved 2/26/19)