Abstract
In the article Prevalence and Contributing Factors of Anxiety and Depression in Patients with Vestibular Migraine, Kim et al. review the current understanding of the pathophysiology that might link vestibular migraine with mood disorders. The article concludes with the statement, “Although the pathophysiology related to VM has not yet been elucidated, it seems likely that peripheral vestibular dysfunction exacerbates anxiety and depression in VM patients.” I would point to the demographic information about these patients and a potential hypothesis for future study. The gender is largely female (83.78%), with an average age of 45.12 years. It is plausible that a common pathophysiology underlying the association between vestibular migraine and mood disorders is one or more shared genetic mutations. 1 These defects might affect neurotransmitters, such as serotonin, or their receptors. The predominance of middle-aged females in this cohort raises the possibility that the trigger of these genetic mutations is hormonal fluctuations, particularly estrogen, that peak during perimenopause. 2
