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Updated: Mar 24, 2026

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Vestibular dysfunction and infratentorial MRI abnormalities in multiple sclerosis.

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    Summary
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    Vestibular symptoms are highly prevalent in people with multiple sclerosis (pwMS), affecting over 90%. Infratentorial lesion burden on MRI is linked to head motion intolerance, suggesting a need for targeted vestibular rehabilitation.

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    Area of Science:

    • Neurology
    • Neuroimaging
    • Vestibular Science

    Background:

    • Vestibular symptoms are common but often under-recognized in people with multiple sclerosis (pwMS).
    • Understanding the link between MRI findings and vestibular dysfunction is crucial for patient management.

    Purpose of the Study:

    • To determine the prevalence of vestibular symptoms in pwMS.
    • To examine associations between infratentorial MRI abnormalities and vestibular symptoms.

    Main Methods:

    • A cross-sectional study involving 80 pwMS.
    • Self-report questionnaires assessed vestibular symptoms.
    • MRI brain scans analyzed for active lesions, middle cerebellar peduncle (MCP) lesion count, and total infratentorial lesion count.

    Main Results:

    • Vestibular symptoms were reported by 92.5% of pwMS.
    • No association found between symptoms and active lesions or MCP lesion counts.
    • Infratentorial lesion burden significantly correlated with head motion intolerance (p = 0.007).

    Conclusions:

    • Vestibular symptoms are highly prevalent in pwMS and frequently under-recognized.
    • Infratentorial lesion counts are a clinically relevant MRI metric for identifying patients at risk of vestibular dysfunction.
    • Early vestibular rehabilitation for patients with high infratentorial lesion burden may improve outcomes and quality of life.