{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:28:22Z","timestamp":1785338902699,"version":"3.55.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate oculomotor, vestibular, reaction time, and cognitive (OVRT-C) function in patients with vestibular migraine (VM) using objective eye-tracking\u2013based metrics and to identify patterns of dysfunction relative to healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vestibular migraine is a common yet underdiagnosed cause of vertigo. Diagnosis remains primarily clinical, because objective neurologic and vestibular findings are often absent or inconsistent. Quantitative methods capable of capturing the multisystem manifestations of VM may improve objective characterization of the disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants with a clinical diagnosis of vestibular migraine were recruited from a tertiary headache center and assessed using a battery of OVRT-C tests administered with a portable eye-tracking system (Spryson Dx-100;\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f52). The test battery assessed gaze stability, saccades, antisaccades, smooth pursuit, vergence, optokinetic responses, and visual and auditory reaction times. Participants also underwent bedside neurologic and vestibular examinations and completed the Dizziness Handicap Inventory (DHI). OVRT-C metrics were compared with normative data from a database of 300 healthy adults. Univariate and stepwise multivariate logistic regression models were used to identify metrics that differentiated VM patients from controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A substantial proportion of VM patients aged 18 to 45 demonstrated abnormal OVRT-C performance compared with normative data, most prominently in horizontal and vertical saccades (54.3 and 51.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001), vertical smooth pursuit (62.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001), optokinetic responses (43.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001), and gaze stability (65.7%). Several OVRT-C metrics showed strong discriminative ability in logistic regression analyses when considering a single OVRT-C metric is considered (adjusted for participant age and gender). A multiple logistic regression model identified six OVRT-C metrics as significant indicators of VM and demonstrated excellent classification performance (AUC\u202f=\u202f0.996), with estimated specificity of 95.9% and sensitivity of 99.7% for probability cutoff of 0.5. Moderate but statistically significant correlations were observed between OVRT-C metrics, bedside neurologic and vestibular findings, and DHI domain scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Objective OVRT-C testing reveals quantifiable abnormalities in oculomotor, vestibular, and cognitive dysfunction in patients with vestibular migraine. These findings support the feasibility of eye-tracking\u2013based multimodal assessments as complementary tools for characterizing vestibular migraine and warrant further validation in larger and longitudinal cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1789811","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:43:17Z","timestamp":1779252197000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Objective oculomotor, vestibular, reaction time, and cognitive signatures of vestibular migraine"],"prefix":"10.3389","volume":"17","author":[{"given":"Claire E. J.","family":"Ceriani","sequence":"first","affiliation":[{"name":"Department of Neurology, Thomas Jefferson University","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandr","family":"Braverman","sequence":"additional","affiliation":[{"name":"Spryson America, Inc.","place":["Pittsburgh, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kiderman","sequence":"additional","affiliation":[{"name":"Spryson America, Inc.","place":["Pittsburgh, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1055\/s-0039-3402735","article-title":"Vestibular migraine I: mechanisms, diagnosis, and clinical features","volume":"40","author":"Baloh","year":"2020","journal-title":"Semin Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1007\/s004150050478","article-title":"Episodic vertigo related to migraine (90 cases): vestibular migraine?","volume":"246","author":"Dieterich","year":"1999","journal-title":"J Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s00415-015-7905-2","article-title":"Vestibular migraine: the most frequent entity of episodic vertigo","volume":"263","author":"Dieterich","year":"2016","journal-title":"J Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1212\/01.wnl.0000237539.09942.06","article-title":"Migrainous vertigo: prevalence and impact on quality of life","volume":"67","author":"Neuhauser","year":"2006","journal-title":"Neurology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1097\/MAO.0000000000001900","article-title":"The epidemiology of vestibular migraine: a population-based survey study","volume":"39","author":"Formeister","year":"2018","journal-title":"Otol Neurotol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1111\/head.13484","article-title":"The spectrum of vestibular migraine: clinical features, triggers, and examination findings","volume":"59","author":"Beh","year":"2019","journal-title":"Headache"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1111\/head.13550","article-title":"Vestibular neuroscience for the headache specialist","volume":"59","author":"Balaban","year":"2019","journal-title":"Headache"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"167","DOI":"10.3233\/VES-2012-0453","article-title":"Vestibular migraine: diagnostic criteria \u2013 consensus document of the B\u00e1r\u00e1ny society and the international headache society","volume":"22","author":"Lempert","year":"2012","journal-title":"J Vestib Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"The international classification of headache disorders, 3rd edition","volume":"38","year":"2018","journal-title":"Cephalalgia"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1111\/head.12129","article-title":"Comparison of interictal vestibular function in vestibular migraine vs migraine without vertigo","volume":"53","author":"Boldingh","year":"2013","journal-title":"Headache"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"4290","DOI":"10.1007\/s12070-021-02953-7","article-title":"Videonystagmography (VNG) findings in patients with vestibular migraine: a hospital-based study","volume":"74","author":"Vivek","year":"2022","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"103152","DOI":"10.1016\/j.amjoto.2021.103152","article-title":"Vestibular and oculomotor function in patients with vestibular migraine","volume":"42","author":"Fu","year":"2021","journal-title":"Am J Otolaryngol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.otorri.2018.10.001","article-title":"Eye movements and imaging in vestibular migraine","volume":"71","author":"ElSherif","year":"2020","journal-title":"Acta Otorrinolaringol Espanola"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1080\/00016480802032785","article-title":"Subclinical deviation of the subjective visual vertical in patients affected by a primary headache","volume":"129","author":"Asai","year":"2009","journal-title":"Acta Otolaryngol"},{"key":"ref15","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":"ref16","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1111\/ene.13815","article-title":"Postural instability during attacks of migraine without aura","volume":"26","author":"Anagnostou","year":"2019","journal-title":"Eur J Neurol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1007\/s00415-009-5132-4","article-title":"Vestibular-evoked myogenic potentials in vestibular migraine","volume":"256","author":"Baier","year":"2009","journal-title":"J Neurol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1177\/0333102411409074","article-title":"Vestibular sensitivity in vestibular migraine: VEMPs and motion sickness susceptibility","volume":"31","author":"Boldingh","year":"2011","journal-title":"Cephalalgia"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e0260351","DOI":"10.1371\/journal.pone.0260351","article-title":"Portable eye-tracking as a reliable assessment of oculomotor, cognitive and reaction time function: normative data for 18-45 year old","volume":"16","author":"Kullman","year":"2021","journal-title":"PLoS One"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1002\/lio2.632","article-title":"Normative data for ages 18-45 for ocular and vestibular testing using eye tracking","volume":"6","author":"Kullman","year":"2021","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"ref21","first-page":"260","volume-title":"Adams and Victor\u2019s Principles of Neurology","author":"Ropper","year":"2014"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s12883-019-1442-z","article-title":"The bucket test differentiates patients with MRI confirmed brainstem\/cerebellar lesions from patients having migraine and dizziness alone","volume":"19","author":"Chang","year":"2019","journal-title":"BMC Neurol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"664","DOI":"10.3390\/brainsci10100664","article-title":"Misperception of visual verticality in patients with primary headache disorders: a systematic review with meta-analysis","volume":"10","author":"Obrero-Gaitan","year":"2020","journal-title":"Brain Sci"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1007\/s11596-021-2418-y","article-title":"The value of subjective visual vertical in diagnosis of vestibular migraine","volume":"41","author":"Li","year":"2021","journal-title":"Curr Med Sci"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1789811\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:43:28Z","timestamp":1779252208000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1789811\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":24,"alternative-id":["10.3389\/fneur.2026.1789811"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1789811","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"article-number":"1789811"}}