Altered functional brain connectivity in patients with visually induced dizziness

Angelique Van Ombergen, Lizette Heine, Steven Jillings, R Edward Roberts, Ben Jeurissen, Vincent Van Rompaey, Viviana Mucci, Stefanie Vanhecke, Jan Sijbers, Floris Vanhevel, Stefan Sunaert, Mohamed Ali Bahri, Paul M Parizel, Paul H Van de Heyning, Steven Laureys, Floris L Wuyts, Angelique Van Ombergen, Lizette Heine, Steven Jillings, R Edward Roberts, Ben Jeurissen, Vincent Van Rompaey, Viviana Mucci, Stefanie Vanhecke, Jan Sijbers, Floris Vanhevel, Stefan Sunaert, Mohamed Ali Bahri, Paul M Parizel, Paul H Van de Heyning, Steven Laureys, Floris L Wuyts

Abstract

Background: Vestibular patients occasionally report aggravation or triggering of their symptoms by visual stimuli, which is called visually induced dizziness (VID). These patients therefore experience dizziness, discomfort, disorientation and postural unsteadiness. The underlying pathophysiology of VID is still poorly understood.

Objective: The aim of the current explorative study was to gain a first insight in the underlying neural aspects of VID.

Methods: We included 10 VID patients and 10 healthy matched controls, all of which underwent a resting state fMRI scan session. Changes in functional connectivity were explored by means of the intrinsic connectivity contrast (ICC). Seed-based analysis was subsequently performed in visual and vestibular seeds.

Results: We found a decreased functional connectivity in the right central operculum (superior temporal gyrus), as well as increased functional connectivity in the occipital pole in VID patients as compared to controls in a hypothesis-free analysis. A weaker functional connectivity between the thalamus and most of the right putamen was measured in VID patients in comparison to controls in a seed-based analysis. Furthermore, also by means of a seed-based analysis, a decreased functional connectivity between the visual associative area and the left parahippocampal gyrus was found in VID patients. Additionally, we found increased functional connectivity between thalamus and occipital and cerebellar areas in the VID patients, as well as between the associative visual cortex and both middle frontal gyrus and precuneus.

Conclusions: We found alterations in the visual and vestibular cortical network in VID patients that could underlie the typical VID symptoms such as a worsening of their vestibular symptoms when being exposed to challenging visual stimuli. These preliminary findings provide the first insights into the underlying functional brain connectivity in VID patients. Future studies should extend these findings by employing larger sample sizes, by investigating specific task-based paradigms in these patients and by exploring the implications for treatment.

Keywords: Functional connectivity; VID; Vertigo; Vestibular; Visually induced dizziness; rsfMRI.

Figures

Fig. 1
Fig. 1
Differences in intrinsic functional connectivity between VID patients and healthy controls. Red regions indicate more intrinsic functional connectivity in VID patients, while the blue regions represent less intrinsic functional connectivity. Results were analyzed in a network-based manner and thresholded with an extended cluster level of p 

Fig. 2

Differences in seed-based functional connectivity…

Fig. 2

Differences in seed-based functional connectivity between healthy controls and VID patients. Two seeds…

Fig. 2
Differences in seed-based functional connectivity between healthy controls and VID patients. Two seeds showing significant differences between healthy controls and VID patients. Seed placement of the thalamus and associative visual areas are represented in the top right corner. Red regions indicate more intrinsic functional connectivity in VID patients, while the blue regions represent less intrinsic functional connectivity. Results were analyzed in a network-based manner and thresholded with a family-wise error corrected extended cluster level of p 
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Fig. 2
Fig. 2
Differences in seed-based functional connectivity between healthy controls and VID patients. Two seeds showing significant differences between healthy controls and VID patients. Seed placement of the thalamus and associative visual areas are represented in the top right corner. Red regions indicate more intrinsic functional connectivity in VID patients, while the blue regions represent less intrinsic functional connectivity. Results were analyzed in a network-based manner and thresholded with a family-wise error corrected extended cluster level of p 

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