Purkinje cells of vestibulocerebellum play an important role in acute vestibular migraine.

Peng Li,Fĕi Li ,Meiyan Feng ,Hongbin Gu ,Chen-Yong Shang ,Jin Xu,Qing Tian,Zhaohuan Zhang,Jianhua Zhuang

doi:10.31083/j.jin.2019.04.1168

Peng Li, Fĕi Li + Show 7 more

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https://doi.org/10.31083/j.jin.2019.04.1168

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Abstract

Both the central and peripheral vestibular systems contribute to the pathogenesis of vestibular migraine, although the mechanism of vestibular migraine remains unclear. To assess central and peripheral vestibular system damage in vestibular migraine and explore the underlying mechanism we performed vestibular function tests, including a caloric test, spontaneous, gaze-evoked nystagmus and saccadic, pursuit and optokinetic eye movements to evaluate the involvement of the central and/or peripheral vestibular system in subjects with acute vestibular migraine episodes. It was found that both peripheral and central vestibular systems were damaged in vestibular migraine patients with the number of subjects with central deficits significantly larger than those with peripheral deficits. The cerebellum, especially the vestibule cerebellum, is the most important part of the central vestibular system. Locculus and paraflocculus are essential structures of cerebellar circuitry controlling vestibular nuclei and oculomotor functions and are anatomically linked with the "migraine pathway". Purkinje cells are the only source of cerebellar output and it innervates inhibitory action. Therefore, we examined the effect of the electric stimulation on paraflocculus Purkinje cells by using a specific electrical stimulation of trigeminal ganglia to induce a migraine-like phenomenon in animal part. Moreover, electrophysiological recordings showed that parafloccular Purkinje cells of rats underwent electrical stimulation of trigeminal ganglia resulted in partial inhibition. It is suggested that Purkinje cells in the paraflocculus could be inhibited after the occurrence of migraine episode and this inhibition may be an important factor leading to vestibular migraine.

Highlights

Migraine and vertigo are two common neurological diseases
It is suggested that Purkinje cells in the paraflocculus could be inhibited after the occurrence of migraine episode and this inhibition may be an important factor leading to vestibular migraine
In the vestibular migraine (VM) group, 47 subjects were characterized as having vertigo, including 18 cases of spontaneous vertigo, 22 cases of positional vertigo, and 7 cases of visually induced vertigo and 41 subjects had motion intolerance. 3.2 Vestibular function of VM and control subjects

Summary

Introduction

Migraine and vertigo are two common neurological diseases. Epidemiological studies have shown that the prevalence of migraine in the vertigo population is far greater than that of the general population, and so is the prevalence of vertigo in the migraine population (Akdal et al, 2015; Teggi et al, 2016; Teixido et al, 2017). The incidence of migraine and vertigo in the general population is 16% and 7%, respectively. It can be predicted that the co-incidence of migraine and vertigo should be around 1.1%. The actual co-incidence of migraine and vertigo is 3.2% (Lempert and Neuhauser, 2009). The link between migraine and dizziness was first described by Edward Liveing in 1873 (Liveing, 1873). During the last three decades, systematic studies of vertigo caused by migraines have received much attention. The diagnostic criteria for VM were published in the third edition of the ICHD (ICHD-3) in 2013, indicating that VM is widely recognized in the field of vestibular headache (Olesen et al, 2013)

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