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Abstract
Objective: To investigate the functional response of neural pathways associated with vestibular stimulation in patients with vestibular migraine (VM).
Methods: Twelve patients with VM underwent whole-brain blood oxygen level–dependent (BOLD) fMRI during ear irrigation with cold water. The functional response of neural pathways to this stimulation in patients with VM was compared with age- and sex-matched patients with migraine without aura and healthy controls. Secondary analyses explored associations between BOLD signal change and clinical features of migraine in patients.
Results: We observed a robust cortical and subcortical pattern of BOLD signal change in response to ear irrigation across all participants. Patients with VM showed a significantly increased thalamic activation in comparison with both patients with migraine without aura and healthy controls. The magnitude of thalamic activation was positively correlated with the frequency of migraine attacks in patients with VM.
Conclusions: We provide novel evidence for abnormal thalamic functional response to vestibular stimulation in patients with VM. These functional abnormalities in central vestibular processing may contribute to VM pathophysiology.
GLOSSARY
- BOLD=
- blood oxygen level–dependent;
- FIR=
- finite impulse response;
- GLM=
- general linear model;
- HC=
- healthy controls;
- ICHD=
- International Classification of Headache Disorders;
- MwoA=
- migraine without aura;
- VM=
- vestibular migraine
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received October 17, 2013.
- Accepted in final form March 7, 2014.
- © 2014 American Academy of Neurology
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