Vestibular and auditory disorders Peer reviewed

The Auxiliary Diagnostic Value of Microsaccades in Vestibular Migraine

Jianhui Qiu, Mingwei Xu, Qin Zhang, Yang Liu and 8 more

The Laryngoscope | Jun 23, 2026

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Although VOR gains in VM patients fall within the normal range, they exhibit pathological microsaccades that differ from those of healthy individuals, characterized by lateral SCC saccades with "high velocity and short latency."

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OBJECTIVES: This study aims to quantitatively analyze vestibulo-ocular reflex (VOR) gain and saccade characteristics during video head impulse testing (vHIT) in patients with vestibular migraine (VM), providing evidence for clinical diagnosis. METHODS: This study included 30 definite VM patients (60 ears) and 30 healthy controls (60 ears). The function of six semicircular canals (SCCs) was evaluated by vHIT. Quantitative parameters of VOR gain and saccades were compared between groups. Benjamini-Hochberg correction was applied (q 0.05). However, in the analysis of saccade parameters, the VM group showed higher peak velocity (q = 0.03) and shorter latency (q = 0.03). No group differences were observed in saccade duration or frequency for lateral SCCs, nor in any saccade parameters for vertical SCCs. ROC analysis identified optimal cutoffs for the first lateral SCC saccade: peak velocity of 83.69°/s (AUC: 0.668, sensitivity: 0.586, specificity: 0.8) and latency of 295.45 ms (AUC: 0.666, sensitivity: 0.69, specificity: 0.582). CONCLUSION: Although VOR gains in VM patients fall within the normal range, they exhibit pathological microsaccades that differ from those of healthy individuals, characterized by lateral SCC saccades with "high velocity and short latency." These quantitative saccade parameters hold promise as supplementary objective indicators to complement traditional VOR gain, offering auxiliary evidence for the clinical diagnosis of VM.

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Jianhui Qiu

first | Nanchang University | ORCID 0000-0002-0645-0809

Mingwei Xu

middle | Shanghai Jiao Tong University | ORCID 0009-0003-6405-6740

Qin Zhang

middle | Shanghai Jiao Tong University | ORCID 0000-0003-1660-029X

Yang Liu

middle | Fuzhou Dermatosis Prevention Hospital

Qiong Wu

middle | Shanghai Jiao Tong University

Yuan Yao

middle | XinHua Hospital

Tianyu Gong

middle | Shanghai Jiao Tong University

Linrui Chen

middle | Nanchang University

Qianqian Zhang

middle | Shanghai Jiao Tong University

M Y Fan

middle | Xi’an Children’s Hospital

Qing Zhang

middle | Shanghai Jiao Tong University | ORCID 0000-0002-5200-3356

Zhiyuan Zhang

last | Nanchang University | ORCID 0000-0003-3845-7420

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BibTeX

@article{Qiu2026Auxiliary,
  title = {The Auxiliary Diagnostic Value of Microsaccades in Vestibular Migraine},
  author = {Jianhui Qiu and Mingwei Xu and Qin Zhang and Yang Liu and Qiong Wu and Yuan Yao and Tianyu Gong and Linrui Chen and Qianqian Zhang and M Y Fan and Qing Zhang and Zhiyuan Zhang},
  journal = {The Laryngoscope},
  year = {2026},
  doi = {10.1002/lary.70698},
  url = {https://doi.org/10.1002/lary.70698}
}

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