Contralateral suppression of otoacoustic emissions in migraine patients without vestibular involvement

Özet: Vestibüler flikayeti olmayan migren hastalar›nda kontralateral otoakustik emisyon süpresyonu Amaç: Bu çal›flman›n amac› duyusal modülasyon bozuklu¤una yol açan migren hastal›¤› olan kiflilerde iflitme sistemi refleksi ölçümünde kullan›lan bir test olan kontralateral otoakustik süpresyon testinin sonuçlar›n›n de¤erlendirilmesidir. Yöntem: Çal›flmaya nöroloji poliklini¤ine baflvuran, Uluslararas› Bafla¤r›s› Derne¤i'nin 2004 y›l› kriterlerine göre migren tan›s› alan ve vestibüler flikayeti olmayan gönüllü migren hastalar› ve sa¤l›kl› gönül-lüler dahil edildi. Bütün gönüllülere tam otolojik muayene, saf ses odyometri testi yap›ld›. Bilateral otoakustik emisyon yan›t› al›nan 30 gö-nüllü migren hastas› ve karfl›laflt›rma için yafl ve cinsiyet özellikleri gö-nüllü hasta grubuna benzeyen 30 sa¤l›kl› gönüllü çal›flmaya dahil edildi. Çal›flmaya dahil edilen gönüllülere kontralateral 50 dB SPL genifl bant gürültü ile maske yap›larak 65 dB click uyaran ile maskeli ve maskesiz otoakustik emisyon ölçümleri yap›ld›. Her iki gruptan elde edilen veriler karfl›laflt›r›ld›. Bulgular: Sa¤l›kl› gönüllülerin de¤erlendirilen 60 kula¤›n›n 40'›nda (%67) süpresyon testi pozitif olarak tespit edilirken migren hastalar›n›n de¤erlendirilen 60 kula¤›ndan 30'unda (%50) süpresyon testi pozitif olarak tespit edildi. Fakat süpresyon pozitifli¤i oranlar›nda ve süpres-yon emisyon de¤erlerinde istatistiksel olarak anlaml› bir fark izlenmedi. ‹ki grup aras›nda istatistiksel olarak anlaml› bir fark olmasa da migrenli grupta kontralateral supresyon cevaplar›nda azalma izlendi. Sonuç: Vestibüler flikayeti olmayan migren hastalar›nda normal kiflilerle karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› olmasa da kontralateral süpresyon cevaplar›nda bir azalma izlenmektedir. Daha büyük seri içeren yeni çal›flmalar ile kontralateral otoakustik emisyon testi vestibüler flikayeti olmayan migren hastalar›nda odyovestibüler flikayetlerin erken tan›s›nda kullanabilece¤i kanaatindeyiz. Anahtar sözcükler: Kontralateral süpresyon testi, MOC refleksi, non-vestibüler migren, otoakustik emisyon. Abstract Objective: Our aim was to investigate contralateral suppression of otoacoustic emission for the evaluation of auditory reflex in patients with migraine which is a disease that may cause dysfunction of sensorial modulation. Methods: Voluntary migraine patients without vestibular symptoms who consulted to Neurology Clinic, and diagnosed according to the IHS 2004 criteria, and healthy volunteers were included in the study. All volunteers underwent complete otorhinolaryngologic and puretone audiometric examinations. Thirty voluntary migraine patients with bilateral otoacoustic emission measurements, and 30 healthy volunteers matched in terms of age and sex were included in the study. Otoacoustic emission measurements were obtained with 65 dB SPL click stimulus with and without mask by masking with contralateral 50 dB SPL broad band noise. Responses were compared between two groups. Results: Positive result was obtained in suppression tests in 40 of 60 (67%) ears of healthy volunteers and in 30 of 60 (50%) ears of migraine patients. However, there was no statistically significant difference between groups regarding positive suppression frequency and suppression values. Even though a statistically significant difference between migraine patients without vestibular involvement and control group was not seen, there was a decrease in contralateral suppression responses in the migraine group. Conclusion: Although it is statistically insignificant, we have demonstrated that migraine patients without vestibular symptoms showed a decrease in the suppression values compared to the healthy volunteers. We believe that in new studies with larger series, contralateral otoacoustic emission suppression test can be used as an early tool to diagnose audiovestibular symptoms in migraine patients without any vestibular involvement