Abstract
IntroductionPrevious voxel‐based morphometry (VBM) studies have revealed changes in brain structure in patients with vestibular migraine (VM); these findings have improved the present understanding of pathophysiology. Few other studies have assessed the association between structural changes and the severity of dizziness in VM. This study aimed to examine the structural changes and cortical morphometric features associated with migraine and vertigo attacks in patients with VM.MethodsTwenty patients with VM and 20 healthy normal volunteers were scanned on a 3‐tesla MRI scanner. The gray matter volume (GMV) was estimated using the automated Computational Anatomy Toolbox (CAT12). The relationship between clinical parameters and morphometric abnormalities was also analyzed in VM.ResultsCompared with controls, VM patients have decreased GMV in the prefrontal cortex (PFC), posterior insula–operculum regions, inferior parietal gyrus, and supramarginal gyrus. Moreover, patient scores on the Dizziness Handicap Inventory (DHI) score showed a negative correlation with GMV in the posterior insula–operculum regions.ConclusionThese findings demonstrated abnormality in the central vestibular cortex and correlations between dizziness severity and GMV in core regions of the vestibular cortex of VM patients, suggesting a pathophysiological role of these core vestibular regions in VM patients.
Highlights
Previous voxel-based morphometry (VBM) studies have revealed changes in brain structure in patients with vestibular migraine (VM); these findings have improved the present understanding of pathophysiology
Some studies on voxel-based morphometry (VBM) have shown that the gray matter volume (GMV) is increased regionally in the frontal, occipital, and angular regions in VM patients compared to controls (Messina et al, 2017; Wang et al, 2019)
These analyses show a reduction in GMV during pain, and the vestibular processing areas may be associated with longer disease duration and increased headache severity (Obermann et al, 2014)
Summary
There is still some debate on the status of vestibular migraine (VM) as a distinct clinical entity Wurthmann et al (2017) found a GMV decrease in the temporal cortex, cingulate cortex, precentral gyrus, hippocampus, dorsolateral prefrontal cortex (PFC), caudate nucleus, and cerebellum These multisensory vestibular cortical areas are involved in central vestibular processing and compensation. Correlation analyses have suggested that VM may induce cumulative effects on the structure of the brain These analyses show a reduction in GMV during pain, and the vestibular processing areas may be associated with longer disease duration and increased headache severity (Obermann et al, 2014). Based on the above-mentioned structural findings, recurrent VM attacks result in morphological alterations in the brain areas that are involved in pain and vestibular processing To avoid limitations from previous studies, our study considered migraine-related clinical questionnaires and incorporated a dizziness-related clinical questionnaire, the Dizziness Handicap Inventory (DHI), to assess the severity of this symptom in patients with VM
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