无前庭症状的偏头痛儿童的亚临床听前庭异常：一项前瞻性病例对照研究
Subclinical audiovestibular abnormalities in children with migraine without vestibular symptoms: A prospective case-control study.
文献信息
| PMID | 42950531 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Şeyma Sönmez Şahin |
| 作者单位 | Göztepe Professor Dr Suleyman Yalcin City Hospital Department of Pediatric Neurology, Istanbul, Türkiye. Electronic address: sonmezseyma@hotmail.com. |
| 期刊 | International journal of pediatric otorhinolaryngology |
| SCI 分区 | Q2 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 偏头痛在成人中与亚临床前庭和听觉功能障碍相关，但对缺乏明显前庭症状的偏头痛儿童进行多领域听前庭综合评估的研究仍然有限。方法：在这项前瞻性病例对照研究中，我们使用扩展高频测听、畸变产物耳声发射、视频头脉冲试验、颈性和眼性前庭诱发肌源性电位以及计算机动态姿势描记，评估了29名无先兆偏头痛儿童（7-18岁）和27名年龄、性别匹配的健康对照者的听前庭功能。结果：连续测量指标的平均值，包括视频头脉冲试验增益和前庭诱发肌源性电位潜伏期，在多重比较校正后组间无显著差异。然而，偏头痛组的分类异常显著更常见，包括视频头脉冲试验功能减退（52%对对照组的11%）、姿势描记前庭比值异常（38%对4%）以及扩展高频听阈升高（38%对7%）。偏头痛儿童异常测试领域总数更多（中位数2对对照组的1），并且提供了所有单一指标中最高的判别准确性（曲线下面积0.799），以两个或以上异常领域为截断值可获得93%的特异性和55%的敏感性。结论：这些发现表明，报告无前庭或听觉症状的无先兆偏头痛儿童，其听前庭异常负担仍高于健康儿童，且异常分布于多个功能领域，而非局限于单一测试。多领域听前庭评估可能揭示无前庭或听觉症状的偏头痛儿童的亚临床异常。
英文摘要
Migraine has been associated with subclinical vestibular and auditory dysfunction in adults, but comprehensive assessment across multiple audiovestibular domains in children with migraine who lack overt vestibular symptoms remains limited. In this prospective case-control study, we evaluated audiovestibular function in 29 children with migraine without aura (ages 7-18 years) and 27 age- and sex-matched healthy controls using extended high-frequency audiometry, distortion product otoacoustic emissions, video head impulse testing, cervical and ocular vestibular evoked myogenic potentials, and computerized dynamic posturography. Mean values for continuous measures, including video head impulse test gain and vestibular evoked myogenic potential latencies, did not differ significantly between groups after correction for multiple comparisons. However, categorical abnormalities were significantly more frequent in the migraine group, including video head impulse test hypofunction (52% versus 11% of controls), an abnormal posturographic vestibular ratio (38% versus 4%), and elevated extended high-frequency hearing thresholds (38% versus 7%). The total number of abnormal test domains was greater in children with migraine (median 2 versus 1 in controls) and provided the highest discriminatory accuracy of any single measure (area under the curve 0.799), with a cutoff of two or more abnormal domains yielding 93% specificity and 55% sensitivity. These findings indicate that children with migraine without aura who report no vestibular or auditory symptoms nonetheless carry a greater burden of audiovestibular abnormality than healthy children, distributed across multiple functional domains rather than confined to a single test. Multidomain audiovestibular assessment may reveal subclinical abnormalities in children with migraine who do not report vestibular or auditory symptoms.