Functional Connectivity Alterations in Benign Paroxysmal Positional Vertigo: Insights from Brain Resting-State...

Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vertigo, which is caused by dislodged calcium carbonate crystals entering the semicircular canals. Previous research suggested multiple brain regions are involved in the central mechanism of BPPV, but the contribution of brain networks to this disorder has not yet been explained. The study aimed to investigate resting-state functional connectivity (FC) differences in patients with BPPV at the level of brain networks to provide support for the central mechanism of this disorder.

Sixty-eight patients with BPPV and 60 matched healthy subjects were recruited in the cross-sectional study. FC of intra- and internetwork from all participants were detected using independent component analysis. Regions with altered intranetwork connectivity were set as seeds to explore whole-brain FC in BPPV. Then the correlations were analyzed between abnormal FC and vestibular function.

Increased intranetwork FC was found within the auditory network, cerebellar network (CN), executive control network, and salience network (SN) in BPPV compared with controls (P < .05, cluster-level, family-wise error corrected). Internetwork FC alterations were shown in auditory network, basal ganglia network, default mode network, and SN in BPPV (P < .01, false discovery rate [FDR] corrected). FC differences of inferior parietal lobule to superior frontal gyrus and precuneus, together between cerebellum VIII-X and VI were observed between 2 groups (P < .05, cluster-level, FDR corrected). Additional analyses presented positive correlation between FC within CN and vertigo intensity (P = .039, FDR corrected).

BPPV is characterized by specific alterations of intra- and internetwork connectivity across several cortical and subcortical regions, which are relevant to the vestibulocerebellar dysfunction in varying degrees. Furthermore, CN connectivity may become a potential neuroimaging target for adjunct clinical intervention of BPPV.