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Abnormal thalamic function in patients with vestibular migraine.

Antonio Russo1, Vincenzo Marcelli1, Fabrizio Esposito1

  • 1From the Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences (A.R., L.M., G.T., A.T.) and MRI Research Center SUN-FISM (A.R., R.C., G.T., A.T.), Second University of Naples; Institute for Diagnosis and Care Hermitage Capodimonte (A.R.), Naples; Department of Neuroscience (V.M., V.C., A.G., E.M.), University of Naples Federico II, Naples; Department of Medicine and Surgery (F.E.), University of Salerno, Baronissi (SA), Italy; and Department of Cognitive Neuroscience (F.E.), Maastricht University, the Netherlands.

Neurology
|May 13, 2014
PubMed
Summary

Patients with vestibular migraine (VM) show abnormal thalamic activation during vestibular stimulation. This heightened brain response may explain the condition

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Area of Science:

  • Neuroscience
  • Neurology
  • Vestibular System

Background:

  • Vestibular migraine (VM) is a disabling neurological disorder.
  • The neural mechanisms underlying VM pathophysiology remain incompletely understood.
  • Investigating functional brain responses to vestibular stimuli is crucial for understanding VM.

Purpose of the Study:

  • To examine the functional neural pathway response to vestibular stimulation in VM patients.
  • To compare brain activation patterns in VM patients with migraine without aura and healthy controls.
  • To explore correlations between brain activity and clinical migraine features.

Main Methods:

  • Whole-brain blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) was employed.
  • Twelve VM patients underwent fMRI during cold-water ear irrigation.
  • Comparisons were made with migraine without aura patients and healthy controls.

Main Results:

  • A significant increase in thalamic activation was observed in VM patients compared to controls.
  • Cortical and subcortical BOLD signal changes occurred in response to vestibular stimulation.
  • Thalamic activation magnitude correlated positively with migraine attack frequency in VM patients.

Conclusions:

  • Novel evidence indicates abnormal thalamic functional response to vestibular stimulation in VM.
  • These central vestibular processing abnormalities may play a role in VM.
  • Findings suggest the thalamus as a potential key area in VM pathophysiology.