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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neuro-Otology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1436127
This article is part of the Research Topic Diving Into the Mystery of Vestibular Migraine View all articles

Migrainous vertigo impairs adaptive learning as a function of uncertainty

Provisionally accepted
Mishaal Sharif Mishaal Sharif 1Oliver Rea Oliver Rea 1Rose Burling Rose Burling 1Mel Ellul Miraval Mel Ellul Miraval 1Rakesh Patel Rakesh Patel 2Yougan Saman Yougan Saman 1Peter Rea Peter Rea 1HaJun Yoon HaJun Yoon 1Amir Kheradmand Amir Kheradmand 3Qadeer Arshad Qadeer Arshad 4*
  • 1 University of Leicester, Leicester, East Midlands, United Kingdom
  • 2 De Monfort University, Leicester, United Kingdom
  • 3 The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • 4 Imperial College London, London, United Kingdom

The final, formatted version of the article will be published soon.

    Objective: Here we examined whether vestibular migraine, as a source of increased perceptual uncertainty due to the associated dizziness, can interfere with adaptive learning.We implemented the IOWA gambling task (IGT) to assess adaptive learning in both heathy controls and patients with migraine related dizziness. Participants were presented with four decks of cards (A, B, C and D), and requested to select a card over 100 trials. Participants received a monetary reward or a penalty with an equal probability when they selected a card. Card decks A and B (high risk decks) involved high rewards (win £100) and high penalties (lose £250) whereas C and D (low risk decks; favourable reward-to-punishment ratio) involved lower rewards (win £50) and penalties (lose £50) Task success required participants to decide (i.e. adaptively learn) through the feedback they received that C and D were the advantageous decks.Results: Analysis revealed that patients with vestibular migraine selected more high-risk cards compared to the control group. Chronic vestibular migraine patients compared to those with acute presentation showed delayed improvement in task performance. Only in acute vestibular migraine patients, we observed that impaired learning positively correlated with measures of dizzy symptoms.Our findings have clinical implications for how vestibular migraine can affect behavioural adaption in patients, either directly through altered perception, or indirectly by impacting cognitive processes that can result in maladaptive behaviour.

    Keywords: Dizziness, Adaptive Learning, risk aversion, Perceptual uncertainty, vestibular migraine

    Received: 21 May 2024; Accepted: 03 Jul 2024.

    Copyright: © 2024 Sharif, Rea, Burling, Ellul Miraval, Patel, Saman, Rea, Yoon, Kheradmand and Arshad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Qadeer Arshad, Imperial College London, London, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.