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Brain Structure and Function

, Volume 219, Issue 4, pp 1355–1367 | Cite as

The differential effects of acute right- vs. left-sided vestibular failure on brain metabolism

  • Sandra Becker-BenseEmail author
  • Marianne Dieterich
  • Hans-Georg Buchholz
  • Peter Bartenstein
  • Mathias Schreckenberger
  • Thomas Brandt
Original Article

Abstract

The human vestibular system is represented in the brain bilaterally, but it has functional asymmetries, i.e., a dominance of ipsilateral pathways and of the right hemisphere in right-handers. To determine if acute right- or left-sided unilateral vestibular neuritis (VN) is associated with differential patterns of brain metabolism in areas representing the vestibular network and the visual–vestibular interaction, patients with acute VN (right n = 9; left n = 13) underwent resting state 18F-FDG PET once in the acute phase and once 3 months later after central vestibular compensation. The contrast acute vs. chronic phase showed signal differences in contralateral vestibular areas and the inverse contrast in visual cortex areas, both more pronounced in VN right. In VN left additional regions were found in the cerebellar hemispheres and vermis bilaterally, accentuated in severe cases. In general, signal changes appeared more pronounced in patients with more severe vestibular deficits. Acute phase PET data of patients compared to that of age-matched healthy controls disclosed similarities to these patterns, thus permitting the interpretation that the signal changes in vestibular temporo-parietal areas reflect signal increases, and in visual areas, signal decreases. These data imply that brain activity in the acute phase of right- and left-sided VN exhibits different compensatory patterns, i.e., the dominant ascending input is shifted from the ipsilateral to the contralateral pathways, presumably due to the missing ipsilateral vestibular input. The visual–vestibular interaction patterns were preserved, but were of different prominence in each hemisphere and more pronounced in patients with right-sided failure and more severe vestibular deficits.

Keywords

Vertigo Vestibular system PET Vestibular neuritis Visual–vestibular interaction 

Abbreviations

BA

Brodmann area

18F-FDG-PET

Fluoro-deoxyglucose positron emission tomography

CMRglc

Cerebral metabolic rate of glucose consumption

SVV

Subjective visual vertical

VN

Vestibular neuritis

VOI

Volume of interest

Notes

Acknowledgments

The work was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft: Di 379/4-3/4), the Foundation “Stiftung Rheinland-Pfalz für Innovation” (961-386261/759), the BMBF (01 GW 0642), and the Hertie-Foundation. Dr. Dieterich, Dr. Bartenstein, Dr. Brandt receive research support from Bundesministerium für Bildung und Forschung (BMBF). Dr. Dieterich serves on the editorial board of Annals of Neurology and received research support from Deutsche Forschungsgemeinschaft. Dr. Brandt receives support from the Hertie-Foundation. Dr. Becker-Bense, Mr. Buchholz, Dr. Schreckenberger report no disclosures.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Sandra Becker-Bense
    • 1
    • 2
    Email author
  • Marianne Dieterich
    • 1
    • 2
    • 5
  • Hans-Georg Buchholz
    • 6
  • Peter Bartenstein
    • 2
    • 3
    • 5
  • Mathias Schreckenberger
    • 6
  • Thomas Brandt
    • 2
    • 4
  1. 1.Department of NeurologyLudwig-Maximilians-University MunichMunichGermany
  2. 2.The German Center for Vertigo and Balance Disorders (IFB-LMU)University of Munich HospitalMunichGermany
  3. 3.Department of Nuclear MedicineLudwig-Maximilians-University MunichMunichGermany
  4. 4.Institute of Clinical NeuroscienceLudwig-Maximilians-University MunichMunichGermany
  5. 5.Munich Cluster for Systems Neurology (SyNergy)MunichGermany
  6. 6.Department of Nuclear MedicineJohannes Gutenberg-UniversityMainzGermany

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