Altered functional brain connectivity in patients with visually induced dizziness.
Vestibular patients occasionally report aggravation or triggering of their symptoms by visual stimuli, which is called visually induced dizziness (VID). These patients therefore experience dizziness, discomfort, disorientation and postural unsteadiness. The underlying pathophysiology of VID is still poorly understood.



The aim of the current explorative study was to gain a first insight in the underlying neural aspects of VID.



We included 10 VID patients and 10 healthy matched controls, all of which underwent a resting state fMRI scan session. Changes in functional connectivity were explored by means of the intrinsic connectivity contrast (ICC). Seed-based analysis was subsequently performed in visual and vestibular seeds.



We found a decreased functional connectivity in the right central operculum (superior temporal gyrus), as well as increased functional connectivity in the occipital pole in VID patients as compared to controls in a hypothesis-free analysis. A weaker functional connectivity between the thalamus and most of the right putamen was measured in VID patients in comparison to controls in a seed-based analysis. Furthermore, also by means of a seed-based analysis, a decreased functional connectivity between the visual associative area and the left parahippocampal gyrus was found in VID patients. Additionally, we found increased functional connectivity between thalamus and occipital and cerebellar areas in the VID patients, as well as between the associative visual cortex and both middle frontal gyrus and precuneus.



We found alterations in the visual and vestibular cortical network in VID patients that could underlie the typical VID symptoms such as a worsening of their vestibular symptoms when being exposed to challenging visual stimuli. These preliminary findings provide the first insights into the underlying functional brain connectivity in VID patients. Future studies should extend these findings by employing larger sample sizes, by investigating specific task-based paradigms in these patients and by exploring the implications for treatment.
Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp. Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium.
Angelique
A
Van Ombergen
Coma Science Group, GIGA Consciousness, University and University Hospital of Liège, Liège, Belgium.
Lizette
L
Heine
Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp. Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium.
Steven
S
Jillings
Neuro-otology Department, Division of Brain Sciences, Imperial College London, London, United Kingdom.
R Edward
RE
Roberts
Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium; iMinds-Vision Lab, Department of Physics, University of Antwerp, Antwerp. Belgium.
Ben
B
Jeurissen
Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Antwerp, Belgium.
Vincent
V
Van Rompaey
Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp. Belgium.
Viviana
V
Mucci
Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Antwerp, Belgium.
Stefanie
S
Vanhecke
Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium; iMinds-Vision Lab, Department of Physics, University of Antwerp, Antwerp. Belgium.
Jan
J
Sijbers
Department of Radiology, Antwerp University Hospital, Edegem, Antwerp, Belgium.
Floris
F
Vanhevel
KU Leuven - University of Leuven, Department of Imaging & Pathology, Translational MRI, Leuven, Belgium.
Stefan
S
Sunaert
GIGA-Cyclotron Research Center - In Vivo Imaging, University of Liège, Liège, Belgium.
Mohamed Ali
MA
Bahri
Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Radiology, Antwerp University Hospital, Edegem, Antwerp, Belgium.
Paul M
PM
Parizel
Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp. Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Antwerp, Belgium.
Paul H
PH
Van de Heyning
Coma Science Group, GIGA Consciousness, University and University Hospital of Liège, Liège, Belgium.
Steven
S
Laureys
Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp. Belgium; Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium.
Floris L
FL
Wuyts
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D001931:Brain Mapping; D004244:Dizziness / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000000981:diagnostic imaging*; D010100:Oxygen / Q000097:blood; D020338:Vestibular Neuronitis / Q000000981:diagnostic imaging*
D010100:Oxygen
Functional connectivity; VID; Vertigo; Vestibular; Visually induced dizziness; rsfMRI