前庭性偏头痛中的认知障碍：基于PubMed的系统综述与荟萃分析。

文献信息

中文摘要

背景： 前庭性偏头痛（VM）是复发性眩晕的主要原因，许多患者描述有认知症状，如“脑雾”、思维迟缓和健忘；然而，VM中客观测量的认知障碍的严重程度和一致性尚未得到明确量化。因此，我们仅对PubMed中2010-2025年、英文、人类的观察性研究进行了系统综述，这些研究报告了VM成人的定量行为认知结局或明确的障碍阈值。两名评价者独立提取数据，并使用ROBINS-I评估偏倚风险。连续结局以标准化均数差（SMD；Hedges g；随机效应REML）进行合并，而VM队列中研究定义的认知障碍患病率则使用Freeman-Tukey转换进行合成；必要时，将中位数和离散度测量值转换为均数和标准差。
结果： 六项研究符合纳入标准，其中四项纳入主要荟萃分析（VM n = 208；健康对照[HC] n = 180）。与HC相比，VM成人表现出较差的整体认知（SMD -0.92，95% CI -1.13至-0.70；I2 = 8%），预测区间为-1.38至-0.45。两项研究中以Stroop表现作为指标的执行功能也提示存在较大缺陷（SMD +1.55，95% CI 0.77-2.33；I2 = 79%），但由于不同Stroop指标导致的高异质性，这一合并估计应作为探索性信号谨慎解读。在VM队列中，研究定义的认知障碍合并患病率为0.74（95% CI 0.66-0.81；I2 = 0%）。
结论： 基于这项聚焦于单一数据库的快速综述，当前证据提示VM成人可能在整体认知和执行控制方面表现出中度至重度下降，支持在常规VM诊疗中考虑认知筛查和多学科管理。未来工作应优先采用标准化认知结局和机制研究，以阐明因果通路并改善临床转化。
系统综述注册： https://inplasy.com/projects/，标识符，INPLASY2025100115。

英文摘要

BACKGROUND: Vestibular migraine (VM) is a leading cause of recurrent vertigo, and many patients describe cognitive symptoms such as "brain fog," slowed thinking, and forgetfulness; however, the magnitude and consistency of objectively measured cognitive impairment in VM have not been clearly quantified. We therefore conducted a PubMed-only systematic review (2010-2025; English; humans) of observational studies reporting quantitative behavioral cognitive outcomes or explicit impairment thresholds in adults with VM. Two reviewers independently extracted data and assessed the risk of bias using ROBINS-I. Continuous outcomes were pooled as standardized mean differences (SMD; Hedges g; random-effects REML), while the prevalence of study-defined cognitive impairment in VM cohorts was synthesized using the Freeman-Tukey transformation; when required, medians and measures of dispersion were converted to means and standard deviations.
RESULTS: Six studies met the inclusion criteria, of which four contributed to the primary meta-analysis (VM n = 208; healthy controls [HC] n = 180). Compared with HC, adults with VM demonstrated poorer global cognition (SMD -0.92, 95% CI -1.13 to -0.70; I2 = 8%), with a prediction interval of -1.38 to -0.45. Executive function, indexed by Stroop performance in two studies, also suggested a large deficit (SMD + 1.55, 95% CI 0.77-2.33; I2 = 79%), though this pooled estimate should be interpreted cautiously as an exploratory signal due to the high heterogeneity driven by differing Stroop metrics. Across VM cohorts, the pooled prevalence of study-defined cognitive impairment was 0.74 (95% CI 0.66-0.81; I2 = 0%).
CONCLUSION: Based on this focused, single-database rapid review, current evidence suggests adults with VM may exhibit moderate-to-large decrements in global cognition and executive control, supporting the consideration of cognitive screening and multidisciplinary management in routine VM care. Future work should prioritize standardized cognitive outcomes and mechanistic studies to clarify causal pathways and improve clinical translation.
SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/projects/, Identifier, INPLASY2025100115.