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Evaluating the rare cases of cortical vertigo using disconnectome mapping
Julian Conrad1,2, Rainer Boegle3,4, Ria Maxine Ruehl3,5
1Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. julian.conrad@med.uni-muenchen.de.
Brain Structure & Function
|July 15, 2022
Summary
Cortical infarcts causing vertigo are linked to disruptions in brain connectivity. Disconnecting the corpus callosum and arcuate fascicle may distinguish vertigo-inducing lesions from those without vertigo.
Area of Science:
- Neuroscience
- Neurology
- Neuroimaging
Background:
- Cortical infarcts can rarely cause vertigo.
- The specific brain network disruptions underlying vertigo from cortical infarcts are not fully understood.
- The parieto-opercular (retro-)insular cortex (PIVC) is implicated in vestibular processing.
Purpose of the Study:
- To investigate structural and functional brain disconnections in patients with acute vertigo due to unilateral ischemic cortical infarcts.
- To compare connectivity patterns in infarcts with vertigo versus those without vertigo in similar locations.
- To focus on the connectivity of the vestibular cortex, specifically the PIVC.
Main Methods:
- Analysis of lesion maps from ten published case reports of cortical infarcts.
- Computation of lesion-functional connectivity networks using data from the Human Connectome Project.
- Evaluation of white matter disconnectome mapping to assess disconnection probability.
Main Results:
- Disconnections of interhemispheric connections via the corpus callosum were present in all vertigo cases but spared in non-vertigo cases.
- The arcuate fascicle was affected in 90% of vertigo-inducing lesions and spared in non-vertigo lesions.
- While the lesion-functional connectivity network involved multiple vestibular and oculomotor areas, it did not solely differentiate between vertigo and non-vertigo lesions.
Conclusions:
- Disruption of interhemispheric PIVC connections (corpus callosum) and intra-hemispheric connections (arcuate fascicle) may be key factors differentiating cortical lesions causing vertigo from those that do not.
- Understanding these specific disconnection patterns can aid in diagnosing and understanding vertigo associated with cortical infarcts.
