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Structural and Functional Changes in the Cerebellum and Brainstem in Patients with Benign Paroxysmal Positional Vertigo

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Abstract

Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular diseases. Since the peripheral vestibular system connects with the cerebellum via the brainstem, repeated episodic vertigo may result in progressive structural and functional changes in the cerebellum and brainstem. In the present work, voxel-based morphometry (VBM) of T1-weighted images and resting-state functional magnetic resonance imaging (fMRI) in 32 patients with BPPV and 32 matched healthy controls were used to assess cerebellar and brainstem anatomical and spontaneous resting-state brain activity alterations associated with BPPV. We used a spatially unbiased infratentorial template toolbox in combination with VBM to analyze cerebellar and brainstem gray matter volume (GMV), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo). Patients with BPPV showed decreased GMV in the right cerebellum posterior lobe/cerebellar tonsil extending to the cerebellum anterior lobe and pons relative to healthy controls. BPPV patients also exhibited significantly higher fALFF values in the right pons and left pons and higher ReHo values in the left cerebellum posterior lobe/Crus2 than the controls. Furthermore, the fALFF z-scores in the pons were positively correlated with the duration of vertigo at baseline and dizziness visual analog scale scores 1 week after canalith repositioning procedures (CRPs). BPPV patients exhibited structural and functional changes in the cerebellum and pons, which may reflect the adaptation and plasticity of these anatomical structures after repeated attacks of episodic vertigo. These results indicate that the changes in pons function may be closely related to residual dizziness after CRPs.

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Funding

This project was funded by grants from the National Natural Science Foundation of China (Nos. 81571658 to X.X. Du, 81271302 to J.R. Liu, and 81401039 to Wei Chen), the research innovation project from Shanghai Municipal Science and Technology Commission (No. 14JC1404300, to J.R. Liu), the “Prevention and Control of Chronic Diseases Project” of Shanghai Hospital Development Center (No. SHDC12015310, to J.R. Liu), the project from SHSMU-ION Research Center for Brain Disorders (No. 2015NKX006, to J.R. Liu), the project from Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support (No. 20161422 to J.R. Liu), the Clinical Research Project from Shanghai Jiao Tong University School of Medicine (No. DLY201614 to J.R. Liu), the Biomedicine Key program from Shanghai Municipal Science and Technology Commission (No. 16411953100 to J.R. Liu), the Shanghai Pujiang Program (18PJD023 to Wei Chen), the Shanghai Medical Guidance Program (17411964000 to Wei Chen), and the Clinical Research Program of Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine (JYLJ202003 to Wei Chen).

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Author notes

  1. Qian Zhu and Wei Chen contributed equally to this work.

Authors and Affiliations

  1. Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, Shanghai, 200062, China

    Qian Zhu, Yangyang Cui, Zhaoxia Qin, Wei Tang, Tingting Gao & Xiaoxia Du

  2. Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China

    Wei Chen, Jing Wu, Liang Shu, Xuhong Sun, Qian Xu, Chun-Yan Jiang & Jianren Liu

  3. Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China

    Wei Chen, Jing Wu, Liang Shu, Xuhong Sun, Qian Xu, Chun-Yan Jiang & Jianren Liu

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  1. Qian Zhu
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Correspondence to Jianren Liu or Xiaoxia Du.

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Zhu, Q., Chen, W., Cui, Y. et al. Structural and Functional Changes in the Cerebellum and Brainstem in Patients with Benign Paroxysmal Positional Vertigo. Cerebellum 20, 804–809 (2021). https://doi.org/10.1007/s12311-021-01237-8

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