{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:57:06Z","timestamp":1770742626097,"version":"3.49.0"},"reference-count":42,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Previous studies reported an increased risk of benign paroxysmal positional vertigo (BPPV) in patients with migraine. Hence, we aimed to assess the risk of migraine in patients with BPPV. This cohort study was conducted using the Taiwan National Health Insurance Research Database. The BPPV cohort consisted of patients aged &lt;45 years with a diagnosis of BPPV between 2000 and 2009. An age- and sex-matched comparison group free from a history of BPPV or migraine was selected. All cases were followed up from 1 January 2000 to 31 December 2010 or until death or a diagnosis of migraine. The baseline demographic characteristics in both groups were compared using Student\u2019s t-test and the chi-square test. Cox proportional hazards regression analysis was used to estimate the hazard ratio for migraine in the BPPV cohort compared with the comparison group after adjustment for age, sex, and comorbidities. Notably, 117 of the 1386 participants with BPPV and 146 of the 5544 participants without BPPV developed migraine. After adjustment for age, sex, and comorbidities, BPPV showed an adjusted hazard ratio indicating a 2.96-fold increased risk of migraine (95% confidence interval: 2.30\u20133.80, p &lt; 0.001). We found that BPPV is associated with an increased risk of a migraine diagnosis.<\/jats:p>","DOI":"10.3390\/ijerph20043563","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T02:27:24Z","timestamp":1676600844000},"page":"3563","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Benign Paroxysmal Positional Vertigo Is Associated with an Increased Risk for Migraine Diagnosis: A Nationwide Population-Based Cohort Study"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5363-5988","authenticated-orcid":false,"given":"I-An","family":"Shih","sequence":"first","affiliation":[{"name":"Department of Public Health, College of Public Health, China Medical University, Taichung 404327, Taiwan"},{"name":"Department of Neurology, Ching Chyuan Hospital, Taichung 428433, Taiwan"},{"name":"Premium Healthcare Center, Chung Shan Medical University Hospital, Taichung 402306, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5632-2733","authenticated-orcid":false,"given":"Chung-Y.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences, China Medical University, Taichung 406040, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-7462","authenticated-orcid":false,"given":"Tsai-Chung","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Public Health, China Medical University, Taichung 404327, Taiwan"},{"name":"Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413305, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuu-Jiun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Department of Neurology, National Yang-Ming Chiao Tung University School of Medicine, Taipei 11217, Taiwan"},{"name":"Institute of Brain Science, National Yang-Ming Chiao Tung University School of Medicine, Taipei 11217, Taiwan"},{"name":"Brain Research Center, National Yang-Ming Chiao Tung University School of Medicine, Taipei 11217, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1056\/NEJMcp1309481","article-title":"Clinical Practice. Benign paroxysmal positional vertigo","volume":"370","author":"Kim","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.otorri.2017.02.007","article-title":"Benign paroxysmal positional vertigo: Diagnostic criteria consensus document of the Committee for the Classification of Vestibular Disorders of the B\u00e1r\u00e1ny Society","volume":"68","author":"Bertholon","year":"2017","journal-title":"Acta Otorrinolaringol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/00005537-199701000-00018","article-title":"Particulate matter in the posterior semicircular canal","volume":"107","author":"Welling","year":"1997","journal-title":"Laryngoscope"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1288\/00005537-199209000-00006","article-title":"Free-floating endolymph particles: A new operative finding during posterior semicircular canal occlusion","volume":"102","author":"Parnes","year":"1992","journal-title":"Laryngoscope"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jns.2016.11.071","article-title":"Migraine affects 1 in 10 people worldwide featuring recent rise: A systematic review and meta-analysis of community-based studies involving 6 million participants","volume":"372","author":"Woldeamanuel","year":"2017","journal-title":"J. Neurol. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1046\/j.1468-2982.2000.00085.x","article-title":"Prevalence of migraine in Taipei, Taiwan: A population-based survey","volume":"20","author":"Wang","year":"2000","journal-title":"Cephalalgia"},{"key":"ref_7","unstructured":"(2004). Headache Classification Subcommittee of the International Headache Society The International Classification of Headache Disorders: 2nd Edition. Cephalalgia, 24, 9\u2013160."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1056\/NEJMra1915327","article-title":"Migraine","volume":"383","author":"Ashina","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_9","unstructured":"(2018). Headache Classification Committee of the International Headache Society (IHS) the International Classification of Headache Disorders, 3rd Edition. Cephalalgia, 38, 1\u2013211."},{"key":"ref_10","unstructured":"(2018). GBD 2016 Headache Collaborators Global, Regional, and National Burden of Migraine and Tension-Type Headache, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016. Lancet Neurol., 17, 954\u2013976."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s00415-009-0149-2","article-title":"Epidemiology of vertigo, migraine and vestibular migraine","volume":"256","author":"Lempert","year":"2009","journal-title":"J. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1177\/0333102414535113","article-title":"Vestibular migraine","volume":"35","author":"Stolte","year":"2015","journal-title":"Cephalalgia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3233\/VES-2011-0423","article-title":"Epidemiological evidence for a link between vertigo and migraine","volume":"21","author":"Neuhauser","year":"2011","journal-title":"J. Vestib. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1177\/0194599810391755","article-title":"Vestibular-evoked myogenic potentials in migrainous vertigo","volume":"144","author":"Hong","year":"2011","journal-title":"Otolaryngol. Head Neck. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.braindev.2005.05.003","article-title":"Neuro-otological features of benign paroxysmal vertigo and benign paroxysmal positioning vertigo in children: A follow-up study","volume":"28","author":"Marcelli","year":"2006","journal-title":"Brain Dev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1093\/brain\/107.4.1123","article-title":"Neuro-otological manifestations of migraine","volume":"107","author":"Kayan","year":"1984","journal-title":"Brain"},{"key":"ref_17","first-page":"85","article-title":"Assessment of migraine-related cochleovestibular symptoms","volume":"122","author":"Bayazit","year":"2001","journal-title":"Rev. Laryngol. Otol. Rhinol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"506","DOI":"10.3389\/fneur.2020.00506","article-title":"Risk factors for the occurrence of benign paroxysmal positional vertigo: A systematic review and meta-analysis","volume":"11","author":"Chen","year":"2020","journal-title":"Front. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4117","DOI":"10.1007\/s00415-020-10175-0","article-title":"Risk factors for benign paroxysmal positional vertigo recurrence: A systematic review and meta-analysis","volume":"268","author":"Chen","year":"2021","journal-title":"J. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/S0140-6736(20)32160-7","article-title":"Migraine: Epidemiology and Systems of Care","volume":"397","author":"Ashina","year":"2021","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lee, S.H., Kim, J.H., Kwon, Y.S., Lee, J.J., and Sohn, J.H. (2021). Risk of vestibulocochlear disorders in patients with migraine or non-migraine headache. J. Pers. Med., 11.","DOI":"10.21203\/rs.3.rs-958934\/v1"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1177\/014556130408301211","article-title":"Migraine and benign paroxysmal positional vertigo: An outcome study of 476 patients","volume":"83","author":"Uneri","year":"2004","journal-title":"Ear Nose Throat J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1017\/S0022215117000536","article-title":"Migraine and benign paroxysmal positional vertigo: A single-institution review","volume":"131","author":"Teixido","year":"2017","journal-title":"J. Laryngol. Otol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/s10194-015-0547-z","article-title":"Migraine is associated with an increased risk for benign paroxysmal positional vertigo: A nationwide population-based study","volume":"16","author":"Chu","year":"2015","journal-title":"J. Headache Pain"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1001\/jamaoto.2018.4016","article-title":"Association between migraine and benign paroxysmal positional vertigo among adults in South Korea","volume":"145","author":"Kim","year":"2019","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1177\/0003489414539921","article-title":"Headache during a cluster of benign paroxysmal positional vertigo attacks","volume":"123","author":"Pollak","year":"2014","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_27","first-page":"133","article-title":"Benign paroxysmal positional vertigo and migraine: Analysis of 186 cases","volume":"10","author":"Faralli","year":"2014","journal-title":"B-ENT"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5935\/0946-5448.20150011","article-title":"Clinical aspects of benign paroxysmal positional vertigo associated with migraine","volume":"19","author":"Yetiser","year":"2015","journal-title":"Int. Tinnitus J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"102650","DOI":"10.1016\/j.amjoto.2020.102650","article-title":"Comparison of associated comorbid conditions in patients with benign paroxysmal positional vertigo with or without migraine history: A large single institution study","volume":"41","author":"Hilton","year":"2020","journal-title":"Am. J. Otolaryngol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s12070-020-02192-2","article-title":"Association between benign positional vertigo and migraine in Indian population","volume":"74","author":"Gupta","year":"2022","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_31","first-page":"e28278","article-title":"Examining Migraine as a predictor of benign paroxysmal positional vertigo onset, severity, recurrence, and associated falls","volume":"14","author":"Kim","year":"2022","journal-title":"Cureus"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/j.1526-4610.1981.hed2105227.x","article-title":"Vertigo, motion sickness and migraine","volume":"21","author":"Kuritzky","year":"1981","journal-title":"Headache"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/MAO.0b013e3181b4e780","article-title":"Otoneurologic dysfunctions in migraine patients with or without vertigo","volume":"30","author":"Casani","year":"2009","journal-title":"Otol. Neurotol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1046\/j.1526-4610.1997.3710615.x","article-title":"Neurotology of migraine","volume":"37","author":"Baloh","year":"1997","journal-title":"Headache"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/000348940010900407","article-title":"Migraine and benign positional vertigo","volume":"109","author":"Ishiyama","year":"2000","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.amjoto.2013.08.021","article-title":"Sudden hearing loss with simultaneous posterior semicircular canal BPPV: Possible etiology and clinical implications","volume":"35","author":"Joshua","year":"2014","journal-title":"Am. J. Otolaryngol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"289","DOI":"10.3389\/fnmol.2018.00289","article-title":"Loss of \u03b1-calcitonin gene-related peptide (ACGRP) reduces otolith activation timing dynamics and impairs balance","volume":"11","author":"Jones","year":"2018","journal-title":"Front. Mol. Neurosci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1093\/brain\/awh542","article-title":"Infarcts in the posterior circulation territory in migraine. the population-based MRI CAMERA study","volume":"128","author":"Kruit","year":"2005","journal-title":"Brain"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1007\/s10072-004-0211-x","article-title":"Neuroradiological features of vertigo","volume":"25","author":"Bruzzone","year":"2004","journal-title":"Neurol. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/WNR.0b013e328364b948","article-title":"Evaluation of vertebrobasilar artery changes in patients with benign paroxysmal positional vertigo","volume":"24","author":"Zhang","year":"2013","journal-title":"Neuroreport"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1046\/j.1526-4610.1999.3901033.x","article-title":"Benign paroxysmal vertigo in childhood: A long-term follow-up","volume":"39","author":"Lindskog","year":"1999","journal-title":"Headache"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.ejpn.2013.01.006","article-title":"Is benign paroxysmal vertigo of childhood a migraine precursor?","volume":"17","author":"Marcos","year":"2013","journal-title":"Eur. J. Paediatr. Neurol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3563\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:39:07Z","timestamp":1760121547000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,17]]},"references-count":42,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20043563"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20043563","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,17]]}}}