{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:09:19Z","timestamp":1777518559337,"version":"3.51.4"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3 Pesquisa do Estado de S\u00c3\u00a3o Paulo","doi-asserted-by":"publisher","award":["2015\/18031-5"],"award-info":[{"award-number":["2015\/18031-5"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3 Pesquisa do Estado de S\u00c3\u00a3o Paulo","doi-asserted-by":"publisher","award":["2017\/07482-1"],"award-info":[{"award-number":["2017\/07482-1"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> It is evidenced that migraineurs present balance deficits. However, the balance recovery following unexpected ground perturbations, which reflect conditions of everyday activities, has not been investigated in this population.<\/jats:p><jats:p><jats:bold>Aim:<\/jats:bold> We aimed to assess the reactive postural responses among patients with migraine with and without aura, chronic migraine, and controls. We further aimed to assess the factors associated with greater self-report of falls.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Ninety patients diagnosed by headache specialists were equally classified into three migraine subgroups according to the presence of aura and chronic migraine. Thirty controls were also recruited. All participants underwent the motor control test (MCT) and adaptation test (ADT) protocols of dynamic posturography tests (EquiTest\u00ae, NeuroCom, USA). Clinical and headache features and information on falls in the previous year, fear of falling, and vestibular symptoms were also assessed.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Patients with aura presented a greater sway area in most of the MCT conditions than the other three groups (<jats:italic>p<\/jats:italic> = 0.001). The aura group also presented delayed latency responses after perturbations compared with controls and patients without aura (<jats:italic>p<\/jats:italic> &amp;lt; 0.03). In the ADT, a greater sway area was observed in patients with aura than in groups without aura, chronic migraine, and controls (<jats:italic>p<\/jats:italic> &amp;lt; 0.0001). The MCT and ADT sway area, the frequency of aura, and the fear of falling explained 46% of the falls in the previous 12 months.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Patients with aura exhibited greater delay and sway area after unexpected ground perturbations than controls and other migraine subgroups, which are related to the reported number of falls.<\/jats:p>","DOI":"10.3389\/fneur.2021.755990","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T12:35:27Z","timestamp":1636374927000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Migraine With Aura Is Related to Delayed Motor Control Reaction and Imbalance Following External Perturbations"],"prefix":"10.3389","volume":"12","author":[{"given":"Gabriela F.","family":"Carvalho","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerstin","family":"Luedtke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carina F.","family":"Pinheiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Moraes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tenysson W.","family":"Lemos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo E.","family":"Bigal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabiola","family":"Dach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debora","family":"Bevilaqua-Grossi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,8]]},"reference":[{"key":"B1","first-page":"239","article-title":"The relevance of clinical balance assessment tools to differentiate balance deficits","volume":"46","author":"Mancini","year":"2010","journal-title":"Eur J Phys Rehabil Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.3389\/fneur.2018.01045","article-title":"Implementation of a central sensorimotor integration test for characterization of human balance control during stance","volume":"9","author":"Peterka","year":"2018","journal-title":"Front Neurol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"321","DOI":"10.11607\/ofph.2029","article-title":"Impaired standing balance in individuals with cervicogenic headache and migraine","volume":"32","author":"Sremakaew","year":"2018","journal-title":"J Oral Facial Pain Headache."},{"key":"B4","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3389\/fneur.2018.00433","article-title":"Postural instability induced by visual motion stimuli in patients with vestibular migraine","volume":"9","author":"Lim","year":"2018","journal-title":"Front Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1111\/head.13009","article-title":"Balance impairments in different subgroups of patients with migraine","volume":"57","author":"Carvalho","year":"2017","journal-title":"Headache."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1111\/head.12135","article-title":"Influence of migraine and of migraine aura on balance and mobility\u2013a controlled study","volume":"53","author":"Carvalho","year":"2013","journal-title":"Headache."},{"key":"B7","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1097\/PHM.0000000000000793","article-title":"Functional balance deterioration on daily activities in patients with migraine: a controlled study","volume":"97","author":"Carvalho","year":"2018","journal-title":"Am J Phys Med Rehabil."},{"key":"B8","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1111\/j.1526-4610.2008.01256.x","article-title":"Is balance normal in migraineurs without history of vertigo?","volume":"49","author":"Akdal","year":"2009","journal-title":"Headache."},{"key":"B9","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s10194-020-01128-z","article-title":"Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients - a cross sectional study","volume":"21","author":"Zorzin","year":"2020","journal-title":"J Headache Pain."},{"key":"B10","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1093\/ptj\/77.5.488","article-title":"The role of limb movements in maintaining upright stance: the \u201cchange-in-support\u201d strategy","volume":"77","author":"Maki","year":"1997","journal-title":"Phys Ther."},{"key":"B11","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.jelekin.2007.06.006","article-title":"An integrated approach towards identifying age-related mechanisms of slip initiated falls","volume":"18","author":"Lockhart","year":"2008","journal-title":"J Electromyogr Kinesiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"ii12","DOI":"10.1093\/ageing\/afl078","article-title":"Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention","volume":"35","author":"Maki","year":"2006","journal-title":"Age Ageing."},{"key":"B13","doi-asserted-by":"publisher","first-page":"117","DOI":"10.3233\/VES-2011-0397","article-title":"Stocktaking on the development of posturography for clinical use","volume":"21","author":"Kingma","year":"2011","journal-title":"J Vestib Res."},{"key":"B14","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/B978-0-444-63916-5.00005-7","article-title":"Balance perturbations","volume":"159","author":"Rogers","year":"2018","journal-title":"Handb Clin Neurol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"International Classification of Headache Disorders, 3rd edition","volume":"38","year":"2018","journal-title":"Cephalalgia."},{"key":"B16","unstructured":"GenevaWHOWHO Global Report on Falls Prevention in Older Age.2007"},{"key":"B17","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1590\/S1413-35552010000300010","article-title":"Cross-cultural adaptation and evaluation of the psychometric properties of the Falls Efficacy Scale-International Among Elderly Brazilians (FES-I-BRAZIL)","volume":"14","author":"Camargos","year":"2010","journal-title":"Rev Bras Fisioter."},{"key":"B18","volume-title":"Balance Manager Systems Clinical Operations Guide","year":"2011"},{"key":"B19","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/PHM.0000000000001095","article-title":"Impairments in postural control and retest reliability of dynamic posturographic measures after lung transplantation","volume":"98","author":"Ebenbichler","year":"2019","journal-title":"Am J Phys Med Rehabil."},{"key":"B20","doi-asserted-by":"publisher","first-page":"E57","DOI":"10.1519\/JPT.0000000000000175","article-title":"Reliability and validity of computerized force platform measures of balance function in healthy older adults","volume":"42","author":"Harro","year":"2019","journal-title":"J Geriatr Phys Ther."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.2522\/ptj.20160099","article-title":"Reliability and validity of force platform measures of balance impairment in individuals with Parkinson disease","volume":"96","author":"Harro","year":"2016","journal-title":"Phys Ther."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2424","DOI":"10.1016\/j.clinph.2008.07.220","article-title":"The clinical utility of posturography","volume":"119","author":"Visser","year":"2008","journal-title":"Clin Neurophysiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1590\/S1413-35552010000300003","article-title":"Revision of posturography based on force plate for balance evaluation","volume":"14","author":"Duarte","year":"2010","journal-title":"Rev Bras Fisioter."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","article-title":"simulation study of the number of events per variable in logistic regression analysis","volume":"49","author":"Peduzzi","year":"1996","journal-title":"J Clin Epidemiol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"49","DOI":"10.3233\/VES-2009-0340","article-title":"Increased vestibular contribution to posture control in individuals with chronic headache","volume":"19","author":"So","year":"2009","journal-title":"J Vestib Res."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2275","DOI":"10.1007\/s00405-014-3179-z","article-title":"Balance control impairment induced after OKS in patients with vestibular migraine: an intercritical marker","volume":"272","author":"Panichi","year":"2015","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"E87","DOI":"10.36076\/ppj\/2016.19.E87","article-title":"Tetra-ataxiometric posturography in patients with migrainous vertigo","volume":"19","author":"Ongun","year":"2016","journal-title":"Pain Physician."},{"key":"B28","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1111\/j.1468-2982.2007.01474.x","article-title":"Migrainous vertigo: clinical, oculographic and posturographic findings","volume":"28","author":"Celebisoy","year":"2008","journal-title":"Cephalalgia."},{"key":"B29","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1111\/ane.12941","article-title":"Subclinical vestibular dysfunction in migraineurs without vertigo: a clinical study","volume":"138","author":"Bernetti","year":"2018","journal-title":"Acta Neurol Scand."},{"key":"B30","doi-asserted-by":"publisher","first-page":"102546","DOI":"10.1016\/j.humov.2019.102546","article-title":"Review of balance recovery in response to external perturbations during daily activities","volume":"69","author":"Tokur","year":"2020","journal-title":"Hum Mov Sci."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1093\/gerona\/glu052","article-title":"Neuroimaging of mobility in aging: a targeted review","volume":"69","author":"Holtzer","year":"2014","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1111\/j.1526-4610.2011.01970.x","article-title":"The point prevalence of dizziness or vertigo in migraine and factors that influence presentation","volume":"51","author":"Calhoun","year":"2011","journal-title":"Headache."},{"key":"B33","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1177\/0333102418769948","article-title":"Presence of vestibular symptoms and related disability in migraine with and without aura and chronic migraine","volume":"39","author":"Carvalho","year":"2019","journal-title":"Cephalalgia."},{"key":"B34","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1111\/j.1468-2982.2008.01808.x","article-title":"Depression, migraine with aura and migraine without aura: their familiality and interrelatedness","volume":"29","author":"Ball","year":"2009","journal-title":"Cephalalgia."},{"key":"B35","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1136\/jnnp-2018-318254","article-title":"Migraine and risk of stroke","volume":"91","author":"Oie","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B36","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s10194-019-0997-9","article-title":"Clinical neurophysiology of migraine with aura","volume":"20","author":"Coppola","year":"2019","journal-title":"J Headache Pain."},{"key":"B37","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1007\/s12311-008-0090-4","article-title":"Reduced cerebellar inhibition in migraine with aura: a TMS study","volume":"8","author":"Brighina","year":"2009","journal-title":"Cerebellum."},{"key":"B38","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s10194-020-01104-7","article-title":"Short-latency afferent inhibition and somato-sensory evoked potentials during the migraine cycle: surrogate markers of a cycling cholinergic thalamo-cortical drive?","volume":"21","author":"Coppola","year":"2020","journal-title":"J Headache Pain."},{"key":"B39","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1177\/1545968319862565","article-title":"Insufficient balance recovery following unannounced external perturbations in persons with stroke","volume":"33","author":"Handelzalts","year":"2019","journal-title":"Neurorehabil Neural Repair."},{"key":"B40","doi-asserted-by":"publisher","first-page":"700","DOI":"10.2522\/ptj.20140090","article-title":"Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials","volume":"95","author":"Mansfield","year":"2015","journal-title":"Phys Ther."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.755990\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T12:35:32Z","timestamp":1636374932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.755990\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,8]]},"references-count":40,"alternative-id":["10.3389\/fneur.2021.755990"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.755990","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,8]]},"article-number":"755990"}}