前庭性偏头痛疾病负担加重及其与精神心理共病的关联研究

doi:10.12183/j.scjpm.2026.0025

摘要/Abstract

摘要： 目的评估前庭性偏头痛患者疾病负担水平,探讨其与精神心理共病关联性,为制定个体化治疗策略提供依据。方法 2024年10月至2025年4月从前庭门诊招募前庭性偏头痛患者388例作为病例组,另招募无前庭症状的典型偏头痛患者388例作为对照组。比较2组一般资料及临床特征;采用偏头痛残疾程度评估量表（MIDAS）、广泛性焦虑障碍量表（GAD-7）、患者健康问卷抑郁量表9（PHQ-9）、偏头痛特异生活质量问卷（MSQOL）评估患者情况,病例组患者额外进行眩晕残障程度评定量表（DHI）测评,分析前庭性偏头痛的疾病负担加重及其与精神心理共病的关系。结果 388例前庭性偏头痛患者中,有13例因问卷无效予以剔除,最终病例组入组375例;388例无前庭症状的典型偏头痛患者中,有18例因问卷无效或主动退出予以剔除,最终对照组入组370例。采用多因素logistic回归分析结果显示,发作频率（OR=6.129）、MSQOL（OR=0.543）是前庭性偏头痛患者单纯焦虑的影响因素（均P<0.05）;发作频率（OR=5.249）、MSQOL（OR=0.576）是前庭性偏头痛患者单纯抑郁的影响因素（均P<0.05）;年龄（OR=8.232）、性别（OR=6.571）、发作频率（OR=9.952）、MIDAS（OR=5.796）、DHI（中度残疾OR=9.138,重度残疾OR=11.816）、直接医疗支出（OR=1.002）、MSQOL（OR=0.421）是前庭性偏头痛患者焦虑合并抑郁的影响因素（均P<0.05）。精神心理共病在前庭性偏头痛患者疾病负担和生活质量间的中介效应,占比为20.00%。结论发作频率、生活质量等因素与前庭性偏头痛患者精神心理共病相关,且精神心理共病在疾病负担和生活质量间起部分中介效应,可为制定个体化治疗策略提供重要依据。

关键词: 前庭性偏头痛, 疾病负担, 焦虑, 抑郁, 生活质量, 精神心理

Abstract: Objective To evaluate the level of disease burden in patients with vestibular migraine and to investigate its association with psychiatric comorbidities, thereby providing a basis for the formulation of individualized treatment strategies. Methods A total of 388 patients diagnosed with vestibular migraine were recruited from a specialized vestibular clinic between October 2024 and April 2025 to form the case group. Concurrently, 388 patients with typical migraine without vestibular symptoms were enrolled as the control group. General demographic data and clinical characteristics were compared between the two groups. Patient assessments were conducted using the Migraine Disability Assessment (MIDAS), the Generalized Anxiety Disorder-7 (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9), and the Migraine-Specific Quality of Life Questionnaire (MSQOL). Patients in the case group also completed the Dizziness Handicap Inventory (DHI). The study analyzed the exacerbation of disease burden in vestibular migraine and its relationship with psychiatric comorbidities. Results Of the 388 vestibular migraine patients, 13 were excluded due to invalid questionnaires, resulting in a final case group of 375 participants. Among the 388 patients with typical migraine, 18 were excluded due to invalid questionnaires or voluntary withdrawal, yielding a final control group of 370 participants. Multivariate logistic regression analysis revealed that attack frequency (OR=6.129) and MSQOL score (OR=0.543) were significant influencing factors for anxiety alone in patients with vestibular migraine (all P<0.05). Similarly, attack frequency (OR=5.249) and MSQOL score (OR=0.576) were identified as significant factors for depression alone (all P<0.05). The influencing factors for comorbid anxiety and depression in this population were age (OR=8.232), gender (OR=6.571), attack frequency (OR=9.952), MIDAS score (OR=5.796), DHI score (moderate disability OR=9.138, severe disability OR=11.816), direct medical expenditure (OR=1.002), and MSQOL score (OR=0.421) (all P<0.05). Psychiatric comorbidities were found to exert a partial mediating effect on the relationship between disease burden and quality of life, accounting for 20.00% of the total effect. Conclusion This study indicates that factors such as attack frequency and quality of life are significantly associated with psychiatric comorbidities in patients with vestibular migraine. Furthermore, psychiatric comorbidities partially mediate the relationship between disease burden and quality of life, providing a crucial evidence base for the development of personalized therapeutic approaches.

Key words: Vestibular migraine, Disease burden, Anxiety, Depression, Quality of life, Psychosomatic comorbidity

中图分类号:

R741

金萍萍, 张明月, 李福来, 郑洁, 郭成浩. 前庭性偏头痛疾病负担加重及其与精神心理共病的关联研究[J]. 华南预防医学, 2026, 52(1): 25-30.

Jin Pingping, Zhang Mingyue, Li Fulai, Zheng Jie, Guo Chenghao. Study on the aggravated disease burden of vestibular migraine and its association with psychosomatic comorbidity[J]. South China Journal of Preventive Medicine, 2026, 52(1): 25-30.

参考文献

[1] Villar-Martinez MD, Goadsby PJ.Vestibular migraine: An update[J]. Curr Opin Neurol, 2024, 37(3): 252-263.
[2] Chen JY, Guo ZQ, Wang J, et al.Vestibular migraine or Meniere's disease: A diagnostic dilemma[J]. J Neurol, 2023, 270(4): 1955-1968.
[3] Hac NEF, Gold DR.Advances in diagnosis and treatment of vestibular migraine and the vestibular disorders it mimics[J]. Neurotherapeutics, 2024, 21(4): e00381.
[4] Tu YH, Huang TC, Tzeng YS, et al.Prevalence, clinical correlates, and functional implications of vestibular symptoms in patients with migraine[J]. Neurology, 2025, 105(9): e214248.
[5] 袁芳, 王麟鹏, 孙敬青, 等. 王麟鹏用帽状腱膜下透刺法治疗前庭性偏头痛1例[J]. 北京中医药, 2024, 43(8): 952-953.
[6] 刘娟, 赵晶, 陈泽雯, 等. 摇头倾斜抑制试验和视频头脉冲试验鉴别前庭性偏头痛和梅尼埃病的应用研究[J]. 中国全科医学, 2024, 27(32): 3993-4000.
[7] 中国医师协会神经内科医师分会疼痛和感觉障碍学组, 中国医药教育协会眩晕专业委员会, 中国研究型医院学会头痛与感觉障碍专业委员会. 前庭性偏头痛诊治专家共识(2018)[J]. 中国疼痛医学杂志, 2018, 24(7): 481-488.
[8] Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version)[J]. Cephalalgia, 2013, 33(9): 629-808.
[9] 丁雷, 刘畅, 王嘉玺, 等. 眩晕残障程度评定量表(中文版)的评价[J]. 中华耳科学杂志, 2013, 11(2): 228-230.
[10] Stewart WF, Lipton RB, Kolodner K, et al.Reliability of the migraine disability assessment score in a population-based sample of headache sufferers[J]. Cephalalgia, 1999, 19(2): 107-114.
[11] 何筱衍, 李春波, 钱洁, 等. 广泛性焦虑量表在综合性医院的信度和效度研究[J]. 上海精神医学, 2010, 22(4): 168-171.
[12] Spitzer RL, Kroenke K, Williams JB.Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire[J]. JAMA, 1999, 282(18): 1737-1744.
[13] Giannouli E, Giannouli E, Alexoudi A, et al.Validity and reliability of the Greek Migraine-Specific Quality of Life Questionnaire (MSQ Version 2.1-GR)[J]. J Patient Rep Outcomes, 2024, 8(1): 72.
[14] Strupp M, Thurtell MJ, Shaikh AG, et al.Pharmacotherapy of vestibular and ocular motor disorders, including nystagmus[J]. J Neurol, 2011, 258(7): 1207-1222.
[15] 董炫妤, 姚晓东. 前庭性偏头痛受生活方式和情绪的影响情况及非药物治疗进展[J]. 新医学, 2025, 56(3): 251-259.
[16] McCray LR, Kim CH, Nguyen SA, et al. Panic disorder in patients with vestibular dysfunction: A systematic review and meta-analysis[J]. Otol Neurotol, 2025, 46(6): 621-626.
[17] Buran S, Balci B, Aktar B, et al.Health-related lifestyle behaviors in patients with vestibular migraine and migraine only: A cross-sectional comparative study[J]. Auris Nasus Larynx, 2025, 52(4): 484-489.
[18] Ibrahim NMK, Hazza NMA, Yaseen DM, et al.Effect of vestibular rehabilitation games in patients with persistent postural perceptual dizziness and its relation to anxiety and depression: Prospective study[J]. Eur Arch Otorhinolaryngol, 2024, 281(6): 2861-2869.
[19] Batinović F, Sunara D, Košta V, et al.Psychiatric comorbidities and quality of life in patients with vestibular migraine and migraine without vertigo: A cross-sectional study from a tertiary clinic[J]. Audiol Res, 2024, 14(5): 778-789.
[20] Kim TS, Lee WH, Heo Y.Prevalence and contributing factors of anxiety and depression in patients with vestibular migraine[J]. Ear Nose Throat J, 2024, 103(5): 305-312.
[21] Sánchez-Sellero I, Soto-Varela A.Relationship between vertigo and consumption of psychotropic drugs: A prospective case-control study[J]. J Clin Med, 2025, 14(8): 2555.
[22] Karababa E, Öçal F C A, Akbaş RN, et al. Psychosocial status and quality of life in patients with Ménière's disease and vestibular migraine[J]. Am J Audiol, 2025, 34(4): 919-926.