Cognitive Problem in Patient with Vestibular Migraine: A Questionnaire Based Study

Abstract

The vestibular system encompasses both peripheral and central connections that extend from the inner ear to the midbrain and further into subcortical structures. Any structural irregularities in this system can potentially result in Vestibular problems. Recent clinical findings indicate that individuals experiencing vertigo often report accompanying cognitive symptoms. These symptoms encompass difficulties with attention, memory, spatial perception, navigation, mental rotation, and the mental representation of three-dimensional space. Although there is increasing research interest in vestibular disorders and cognition, the relationship between specific vestibular disorders and cognition has been less explored. Thus, this study aimed to determine whether there are any cognitive problems associated with patients diagnosed with Vestibular Migraine. A non-experimental standard group comparison research design was employed, involving a total of 65 participants. Among them, Group-I consisted of 25 individuals (with a mean age of 32.68 years) considered clinically normal, while Group II included 40 participants (with a mean age of 40.35 years) diagnosed with Vestibular Migraine. The study was conducted using an online/tele-mode, where a questionnaire was sent to the participant via email/WhatsApp. This questionnaire comprised 10 questions related to cognition, primarily selected from the Neurobehavioral Cognitive Status Examination (NCSE), along with demographic details that participants were required to complete. For each response, a score of 0 was assigned for "Yes," 1 for "Sometimes," and 2 for "No" for subsequent analysis. The maximum achievable score was 20, while the minimum possible score was 0. Higher scores indicated fewer cognitive-related problems, whereas lower scores suggested more cognitive issues. The collected data was analyzed using the Shapiro-Wilk's test, revealing a nonnormally distributed dataset. Subsequently, a Mann-Whitney U test was conducted, and results showed a significant difference in scores between Group I and Group II (p<0.05). Chi-square tests were performed to analyze responses to the ten cognitionrelated questions in relation to the overall scores assigned. These tests indicated that responses were dependent on the groups; in Group I, the number of individuals with cognitive problems was lower (resulting in higher overall scores), whereas in Group II, the number of individuals with cognitive problems was higher (resulting in lower overall scores). An independent sample t-test was carried out to investigate the impact of associated problems like hypertension and hearing loss within the groups. The results showed no significant difference in responses within the groups, with no significant disparity found (p>0.05). Additionally, a Shapiro-Wilk's test was conducted for diabetes data, which also exhibited a non-normally distributed pattern. A Mann- Whitney U test was then employed for within-group comparison, and the results indicated no significant difference [/Z/= -0.310, p=0.756]. The findings from the present study suggest a noteworthy association between cognitive issues in participants diagnosed with vestibular migraine. This aligns with prior research highlighting the vestibular system's role in cognitive function, indicating that vestibular disorders could potentially lead to challenges related memory, concentration, thinking, and distractibility exhibited notable impairments and other cognitive difficulties. Establishing a connection between cognition and vestibular disorders can contribute to more comprehensive diagnostic approaches and rehabilitation, ultimately enhancing the quality of life for patients.