title: Unilateral vestibular failure suppresses cortical visual motion processing.
abstract: Patients with unilateral vestibular failure (UVF) experience oscillopsia (apparent motion of the visual scene) during rapid head movements due to increased retinal slip caused by vestibulo-ocular reflex impairment. Oscillopsia is always smaller than the net retinal slip and decreases over time in patients with acquired vestibular loss; this correlates with increased thresholds for visual motion detection and increased tolerance to retinal slip. We investigated the underlying cortical adaptive processes using visual motion stimulation during blood oxygen level-dependent (BOLD) fMRI. Optokinetic nystagmus was elicited in seven patients with right-sided and seven patients with left-sided unilateral vestibular neurectomy and in seven age- and gender-matched healthy controls. Patients showed diminished activation of bilateral visual cortex areas (including the motion-sensitive area MT/V5, cuneus, middle occipital, fusiform and lingual areas) and ocular motor regions compared to their controls during visual motion stimulation. Concurrent BOLD signal decreases of temporo-parietal and insular multisensory cortical areas occurred in controls and patients. The diminished activation of visual motion processing areas plausibly reflects an adaptive mechanism that suppresses distressing oscillopsia in patients with UVF and thereby stabilizes the perceived visual surroundings. This study provides for the first time neuroimaging evidence of suppressed cortical visual motion processing in patients with vestibulopathy.
authors.affiliation: Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University, Marchioninistrasse 15, 81377 Munich, Germany. angela.deutschlaender@med.uni-muenchen.de
authors.forename: Angela
authors.initials: A
authors.lastname: Deutschländer
authors.forename: Katharina
authors.initials: K
authors.lastname: Hüfner
authors.forename: Roger
authors.initials: R
authors.lastname: Kalla
authors.forename: Thomas
authors.initials: T
authors.lastname: Stephan
authors.forename: Thomas
authors.initials: T
authors.lastname: Dera
authors.forename: Stefan
authors.initials: S
authors.lastname: Glasauer
authors.forename: Martin
authors.initials: M
authors.lastname: Wiesmann
authors.forename: Michael
authors.initials: M
authors.lastname: Strupp
authors.forename: Thomas
authors.initials: T
authors.lastname: Brandt
mesh_terms: D001931:Brain Mapping / Q000379:methods; D005260:Female; D019416:Head Movements; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009039:Motion Perception; D009473:Neuronal Plasticity; D017120:Nystagmus, Optokinetic; D010468:Perceptual Disorders / Q000209:etiology* / Q000503:physiopathology; D010775:Photic Stimulation / Q000379:methods; D012027:Reflex, Vestibulo-Ocular; D014722:Vestibule, Labyrinth / Q000503:physiopathology / Q000601:surgery*; D014793:Visual Cortex / Q000503:physiopathology