Wypych Aleksandra, Serafin Zbigniew, Marzec Maria, Osiński Stanisław, Sielski Łukasz, Kaźmierczak Henryk, Pawlak-Osińska Katarzyna
The Interdisciplinary Center for Modern Technologies, Nicolaus Copernicus University, Toruń, Poland.
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Neuroradiology. 2019 May;61(5):585-593. doi: 10.1007/s00234-019-02194-0. Epub 2019 Mar 16.
A combination of the caloric test with functional magnetic resonance imaging (fMRI) is a promising method for a comprehensive diagnostics of pathologies of the vestibular system. The aim of this study was to investigate the potential pattern of grey matter local activation in fMRI using cold and hot caloric stimulation in patients presenting unilateral peripheral vestibular injury.
Forty right-handed participants aged 27 to 56 with the diagnosis of right-sided peripheral vestibular hypofunction were included. Stimulation was performed separately for the right and the left ear with cold (C, 14-15 °C) stimulus and hot (H, 48-49 °C) stimulus. Grey matter activation was assessed in BOLD technique using a 3T scanner.
We observed activity within the parieto-insular vestibular cortex (PIVC), thalamus, insula and retroinsular area, hippocampus, and cerebellum, as well as oculomotor centers located in the precentral gyrus, superior temporal gyrus, and intraparietal sulcus. Cold stimulus resulted in more areas of activation in response to the right ear activation rather than to the left ear. The ipsilateral activity was noted for insular cortex and intraparietal sulcus. The differences between hot and cold stimuli were noted for the right ear.
In this preliminary study, the combination of the caloric test and fMRI allowed to present specific pattern of grey matter activation in patients with unilateral peripheral vestibular injury. Further studies are necessary to develop patterns or cortical maps differentiating various balance disorders and to analyze the dynamics of cortical plasticity after the injury.
将冷热试验与功能磁共振成像（fMRI）相结合，是一种对前庭系统病变进行综合诊断的有前景的方法。本研究的目的是调查在单侧外周前庭损伤患者中，使用冷热刺激进行fMRI时灰质局部激活的潜在模式。
纳入40名年龄在27至56岁之间、诊断为右侧外周前庭功能减退的右利手参与者。分别用冷刺激（C，14 - 15°C）和热刺激（H，48 - 49°C）对右耳和左耳进行刺激。使用3T扫描仪通过血氧水平依赖（BOLD）技术评估灰质激活情况。
我们观察到顶叶 - 岛叶前庭皮质（PIVC）、丘脑、岛叶和岛后区域、海马体、小脑以及位于中央前回、颞上回和顶内沟的动眼神经中枢有活动。冷刺激导致右耳激活时的激活区域比左耳更多。岛叶皮质和顶内沟出现同侧活动。右耳的冷热刺激之间存在差异。
在这项初步研究中，冷热试验与fMRI相结合能够呈现单侧外周前庭损伤患者灰质激活的特定模式。需要进一步研究以建立区分各种平衡障碍的模式或皮质图谱，并分析损伤后皮质可塑性的动态变化。
