Investigation of Imagery Abilities in Individuals With Migraine

The numeric pain scale is used to assess the severity of a headache.The pain a person feels is evaluated on a scale from "0: no pain at all" to "10: I feel very severe pain."

The Movement Imagery Questionnaire-3 is the most up-to-date version of the Movement Imagery Questionnaire and the Movement Imagery Questionnaire-Revised, Second Edition.The questionnaire consists of 12 items and separately evaluates external, internal, and kinesthetic imagery abilities. After each imagery task, individuals rate their experience on a scale from 1 to 7 (1 - very difficult to feel/see, 7 - very easy to feel/see).

The ability to imagine movement is used to test the controllability component of imagery (CC). It is defined as the ability to manipulate, transform, or maintain an imagined body movement over time

The administration of questionnaires is quite easy and quick. However, the subjectivity arising from individuals rating themselves in these questionnaires should not be overlooked. Mental chronometry can be defined as the time required by the neural system to process information. It is based on a different foundation than the questionnaires mentioned above. Mental chronometry is a parameter that measures the duration of motor imagery and is based on the assumption that the time required to perform a movement is the same as the time needed to imagine it. Compared to questionnaires, mental chronometry is a more objective measure; however, it does not evaluate the clarity or vividness of imagery. Mental chronometry measurements are planned to be carried out using the method described by Oostra et al.

Mental Rotation is one of the visuospatial abilities and can be simply defined as the mental rotation of objects in three dimensions. To evaluate mental rotation ability, three-dimensional objects such as cubes or body parts like the hands and feet can be used. Mental rotation ability is frequently assessed using hand images. The basic principle of hand mental rotation tests is to determine whether a hand image, presented from different angles and orientations, belongs to the right or left hand. In our study, since we focus on the neck region and balance ability, the Recognise Neck and Foot applications, which include images of the neck and feet, will be used.

The task is to perform visual motor imagery and kinesthetic motor imagery in accordance with the instructions, taking into account the tasks included in the Movement Imagery Questionnaire-3.The stimuli will be presented via projection onto a mirror mounted on the head coil of the Functional Magnetic Resonance Imaging scanner. All participants will first be instructed to perform visual motor imagery (first-person internal egocentric imagery) and then kinesthetic motor imagery. The procedure is planned to be carried out using the method applied by Kwon et al.

The Montreal Cognitive Assessment is a neuropsychological test used to evaluate cognitive domains such as memory, attention, executive functions, visuospatial abilities, language, abstraction, and orientation. The scale includes items assessing attention and concentration, executive functions, memory, language, visuospatial skills, abstract thinking, calculation, and orientation.

The total score ranges from 0 to 30. In the standardization study conducted in our country, the cutoff score for distinguishing healthy individuals from those with mild cognitive impairment was determined as 21.

The Migraine Disability Assessment scale measures headache-related disability and includes five functional questions related to work, school, and household activities. The MIDAS score is calculated by counting the number of days in which the patient's performance is reduced or absent.

The Cervical Joint Position Sense Test is used to assess cervical position sense. In this test, a laser pointer attached to the participant's head and a board with concentric circles drawn at 1 cm intervals are used. Participants are asked to sit on a chair with back support. The distance between the panel and the participant is set at 90 cm. The laser pointer is aligned with the center of the board. Participants are asked to close their eyes and memorize this central point.

Proprioception measurement is planned using a Dualer IQ Pro Digital Inclinometer with a repositioning test during trunk flexion. A target angle of 30° flexion is used.

The Fremantle Neck Awareness Questionnaire is a 9-item questionnaire that evaluates attention, proprioceptive sensation (body awareness), neglect, and the perception of the neck's shape and size. A higher score on the Fremantle Neck Awareness Questionnaire indicates lower neck awareness.

Balance assessment will be performed using the HUR Smart Balance device on both firm and soft surfaces, with eyes open and closed.

Body Awareness Questionnaire: The Body Awareness Questionnaire was developed by Shields et al., and its Turkish validity and reliability study was conducted by Seda Karaca. It is a questionnaire designed to assess the level of awareness of body composition. Participants are asked to rate each item on a scale from 1 to 7 (1 = not at all true for me, 7 = completely true for me). The total score ranges from a minimum of 18 to a maximum of 126. An increase in the total score indicates a higher level of body awareness.

The Tampa Scale for Kinesiophobia was used to assess fear of movement (kinesiophobia). The aim of this scale is to distinguish between individuals with normal responses and those with high levels of fear of movement. The scale consists of 17 items and uses a 4-point Likert scoring system. Higher scores indicate greater fear of movement. In studies, the use of the total score is recommended.

The Vertigo Symptom Scale is a subjective questionnaire that measures vertigo, dizziness, and autonomic-anxiety symptoms experienced within the last month. In this study, the 15-item short form will be used. Of the 15 items, 8 are related to vertigo and balance, and 7 are related to autonomic-anxiety symptoms. Each item is scored on a 0-4 scale: never (0 points), very rarely (1 point), sometimes (2 points), often (3 points), and very often (4 points). The total score ranges from 0 to 60, with higher scores indicating more severe impairment. A total score of 12 or above is considered clinically significant.

The Dizziness Handicap Inventory is a 25-item self-report questionnaire that evaluates the impact of dizziness and vertigo on quality of life. The items are designed to assess functional, physical, and emotional changes.Each question has three response options: yes, sometimes, and no. Responses are scored as 4 points for yes, 2 points for sometimes, and 0 points for no. The maximum possible score is 100. Higher scores indicate more severe dizziness-related disability.

The Hospital Anxiety and Depression Scale was developed for use in non-psychiatric clinical settings to assess anxiety and depression. It is used to identify these psychiatric comorbidities. Individuals scoring above 10 on the anxiety subscale and above 7 on the depression subscale are considered to be at risk for anxiety and depression.