스트레스와 편두통에 연관된 어지럼증

국문 초록 (Abstract)

스트레스에 유발되는 편두통 환자들에 어지럼증이 자주 일어난다. 편두통에 연관된 어지럼증(migraine-related dizziness, MRD)은 아직 그 병태생리가 분명히 알려지지 않았다. 스트레스에 의해 유발되고 어지럼증과 연관된 편두통 환자의 평형기능을 정량적으로 알아보고자 하였다. MRD로 진단받은 환자 35명을 대상으로 하고, 편두통이 있으면서 어지럼증은 없는 환자들을 나이와 성별로 짝지워 대조군으로 하였다. 설문지로 스트레스를 평가하고 전정유발근전위검사(VEMP)가 포함된 전정기능검사 및 자세측정기 검사를 시행하였다. 결과로 MRD 환자들이 대조군보다 스트레스가 많았다. VEMP 진폭은 MRD 환자군이 대조군보다 통계적으로 유의하게 저하되었다. MRD 환자들의 압력의 중심 동요 궤적은 1.0 Hz 이상의 높은 동요 주파수영역에서 파워가 대조군보다 유의하게 컸다. 전산화동적자세 측정기를 사용한 감각분석에서 전정비는 MRD 환자군이 유의하게 저하되었다. 이로 보아 스트레스는 편두통에 연관된 어지러움과 밀접한 인과관계가 있을 것이며 MRD 환자들은 미로 기능 및 전정둔덕반사에 이상이 있을 것으로 추측된다. 이러한 전정계 이상이 말초성 병변 뿐 아니라 중추성 병변에서 왔을 가능성을 제기하는 결과로 사료된다.

다국어 초록 (Multilingual Abstract)

Migraine-related dizziness (MRD) refers to a disorder in which vestibular symptoms are an integral part of migraine symptomatology. The purpose of this study was to assess the magnitude of subclinical balance dysfunction in migraine patients quantitatively and to define the pathophysiology of MRD better. Thirty-three patients with acute MRD were enrolled. Their scores on the measures of balance were compared with untreated age and sex matched migrainous patients without dizziness. The questionnaires for stress amount were asked to both groups. All the subjects underwent balance measurements that included vestibular evoked myogenic potential (VEMP) testing. The spectral frequency analysis of body sway while standing upright was investigated. Sensory organization tests were done by computerized dynamic posturography. There was a significant increment in the level of stress at MRD group. MRD patients had reduced VEMP amplitudes compared to the controls. MRD group’s center-of-pressure sway showed a significant increase in spectral power at high frequencies. Computerized dynamic posturography showed decreased vestibular ratio in the patients with MRD. These results suggest that stress may induce abnormal vestibulo-collic reflex and disequilibrium in MRD people. The pathogenesis of MRD is likely related to both peripheral and central vestibular structure disturbances. (Korean J Str Res 2009;17:359∼367)

목차 (Table of Contents)

• 서론
• 재료 및 방법
• 결과
• 고찰
• 참고문헌
• 초록

참고문헌 (Reference)

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