{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:25:18Z","timestamp":1781713518717,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"publisher","award":["TL1TR001415"],"award-info":[{"award-number":["TL1TR001415"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effectiveness of nortriptyline regimen and migraine dietary\/lifestyle modifications on dizziness and stress levels in patients diagnosed with vestibular migraine (VM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 35 patients diagnosed with definite VM based on the International Classification of Headache Disorders were included in this intervention study. Patients self\u2010selected to receive either nortriptyline regimen alone (10\u201340\u2009mg daily with biweekly escalation) (group A, <jats:italic>n<\/jats:italic>\u2009=\u200917) or migraine dietary\/lifestyle modifications alone (group B, <jats:italic>n<\/jats:italic>\u2009=\u200918). Main outcome measures were dizziness severity and stress level measured by the visual analog scale (VAS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 4\u2010week post\u2010treatment, dizziness decreased from 6.0\u2009\u00b1\u20092.5 to 4.2\u2009\u00b1\u20093.4 (<jats:italic>p<\/jats:italic>\u2009=\u20090.069) in group A and from 8.7\u2009\u00b1\u20091.5 to 3.6\u2009\u00b1\u20093.0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in group B. VAS for stress changed from 5.5\u2009\u00b1\u20091.3 to 5.4\u2009\u00b1\u20092.9 (<jats:italic>p<\/jats:italic>\u2009=\u20090.93) and from 6.9\u2009\u00b1\u20093.2 to 5.0\u2009\u00b1\u20092.7 (<jats:italic>p<\/jats:italic>\u2009=\u20090.025) in groups A and B, respectively. The <jats:italic>\u03b4<\/jats:italic> values of the VAS score for dizziness were 1.8\u2009\u00b1\u20093.7 and 5.1\u2009\u00b1\u20093.1 and the <jats:italic>\u03b4<\/jats:italic> values of the VAS score for stress were 0.06\u2009\u00b1\u20092.9 and 1.9\u2009\u00b1\u20093.3 in groups A and B, respectively. Quality of life (QOL) improved in 88% patients in group A and 94% patients in group B.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nortriptyline, at a maximum dose of 40\u2009mg, effectively alleviates patient symptoms, while a migraine diet and lifestyle modifications notably reduce vertiginous symptoms and stress levels in VM patients in 4\u2009weeks. Both interventions are equally effective in ameliorating the QOL of patients. The ideal treatment for patients would likely need to include both medication and diet\/lifestyle changes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.14231","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T05:03:59Z","timestamp":1727413439000},"page":"62-67","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy of Nortriptyline and Migraine Lifestyle Modifications in Vestibular Migraine Management"],"prefix":"10.1111","volume":"50","author":[{"given":"Madelyn","family":"Frank","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Tawk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4450-0798","authenticated-orcid":false,"given":"Ella J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2606-6027","authenticated-orcid":false,"given":"Joshua K.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdula","family":"Al\u2010Seraji","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3585-698X","authenticated-orcid":false,"given":"Mehdi","family":"Abouzari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid R.","family":"Djalilian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"},{"name":"Department of Biomedical Engineering University of California  Irvine California USA"},{"name":"Department of Neurosurgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63437-5.00005-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-317"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-307601"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13281"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-201644"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001900"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28546"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010600.pub2"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3402067"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1332973"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000023752"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/08039488.2014.972976"},{"key":"e_1_2_11_14_1","volume-title":"R: A Language and Environment for Statistical Computing. 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