Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Psychology, Shanghai University of Sport, Shanghai, China.
Brain Behav. 2024 Oct;14(10):e70053. doi: 10.1002/brb3.70053.
This study aimed to analyze the features of resting-state functional magnetic resonance imaging (rs-fMRI) and clinical relevance in patients with benign paroxysmal positional vertigo (BPPV) that have undergone repositioning maneuvers.
A total of 38 patients with BPPV who have received repositioning maneuvers and 38 matched healthy controls (HCs) were enrolled in the present study from March 2018 to August 2021. Imaging analysis software was employed for functional image preprocessing and indicator calculation, mainly including the amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), percent amplitude of fluctuation (PerAF), and seed-based functional connectivity (FC). Statistical analysis of the various functional indicators in patients with BPPV and HCs was also conducted, and correlation analysis with clinical data was performed.
Patients with BPPV displayed decrease in ALFF, fALFF, and PerAF values, mainly in the bilateral occipital lobes in comparison with HCs. Additionally, their ALFF and fALFF values in the proximal vermis region of the cerebellum increased relative to HCs. The PerAF values in the bilateral paracentral lobules, the right supplementary motor area (SMA), and the left precuneus decreased in patients with BPPV and were negatively correlated with dizziness visual analog scale (VAS) scores 1 week after repositioning (W1). In addition, in the left fusiform gyrus and lingual gyrus, the PerAF values show a negative correlation with dizziness handicap inventory (DHI) scores at initial visit (W0). Seed-based FC analysis using the seeds from differential clusters of fALFF, ALFF, and PerAF showed reductions between the left precuneus and bilateral occipital lobe, the left precuneus and left paracentral lobule, and within the occipital lobes among patients with BPPV.
The spontaneous activity of certain brain regions in the bilateral occipital and frontoparietal lobes of patients with BPPV was reduced, whereas the activity in the cerebellar vermis was increased. Additionally, there were reductions in FC between the precuneus and occipital cortex or paracentral lobule, as well as within the occipital cortex. The functional alterations in these brain regions may be associated with the inhibitory interaction and functional integration of visual, vestibular, and sensorimotor systems. The functional alterations observed in the visual cortex and precuneus may represent adaptive responses associated with residual dizziness.
本研究旨在分析接受变位治疗后的良性阵发性位置性眩晕（BPPV）患者的静息态功能磁共振成像（rs-fMRI）特征及其与临床的相关性。
本研究纳入了 2018 年 3 月至 2021 年 8 月期间接受变位治疗的 38 例 BPPV 患者和 38 名匹配的健康对照者（HCs）。采用影像分析软件对功能图像进行预处理和指标计算，主要包括低频振幅（ALFF）、分数低频振幅（fALFF）、波动幅度百分比（PerAF）和基于种子的功能连接（FC）。还对 BPPV 患者和 HCs 的各项功能指标进行了统计学分析，并与临床数据进行了相关性分析。
与 HCs 相比，BPPV 患者的双侧枕叶的 ALFF、fALFF 和 PerAF 值降低，小脑蚓部近端的 ALFF 和 fALFF 值升高。BPPV 患者双侧旁中央小叶、右侧辅助运动区（SMA）和左侧楔前叶的 PerAF 值降低，与变位治疗后 1 周（W1）的眩晕视觉模拟量表（VAS）评分呈负相关。此外，在左侧梭状回和舌回，PerAF 值与初次就诊时（W0）的眩晕残障量表（DHI）评分呈负相关。使用 fALFF、ALFF 和 PerAF 的差异聚类的种子进行基于种子的 FC 分析显示，BPPV 患者的左侧楔前叶与双侧枕叶、左侧楔前叶与左侧旁中央小叶以及枕叶内的 FC 减少。
BPPV 患者双侧枕叶和额顶叶某些脑区的自发活动减少，而小脑蚓部的活动增加。此外，楔前叶与枕叶皮质或旁中央小叶之间以及枕叶皮质内的 FC 减少。这些脑区的功能改变可能与视觉、前庭和感觉运动系统的抑制性相互作用和功能整合有关。在视觉皮质和楔前叶观察到的功能改变可能代表与残余头晕相关的适应性反应。
